Fig. 2.

Surgical technique. One centimetre incision at the level of the neck of the 1st metatarsal bone (a). Exposure of the metatarsal neck (b). Metatarsal neck osteotomy using a pneumatic saw (c). Inclination of the osteotomy in the frontal plane, in order to maintain or modify the length of the first metatarsal bone (modified with kind permission from Springer Science+Business Media: Clin Orthop Relat Res. Giannini S, et al. The SERI Distal Metatarsal Osteotomy and Scarf Osteotomy Provide Similar Correction of Hallux Valgus. 2013 Epub Mar 14; Fig. 4b) (d). Kirschner wire insertion through the skin incision in a proximal-distal direction into the medial soft tissue adjacent to the bone (e). Kirschner wire is retaken from the tip of the toe (f) until its proximal end reaches the osteotomy line (g). Displacement of the metatarsal head to correct the pathoanatomy of the deformity (h). Kirschner wire reinsertion into the diaphyseal channel of the metatarsal bone, guided by the grooved lever, to stabilise the correction (i). Removal of a small bone wedge from the proximal stump of the osteotomy, if medially prominent (j)