Evan's osteotomy should be avoided in which condition?

Evan's osteotomy should be avoided in which condition?

• A. Metatarsus adductus
• B. Hallux valgus
• C. Pes planus
• D. Metatarsus varus

Answer: (A)

Evan’s osteotomy targets the first metatarsal to correct hallux valgus by creating a realignment of the distal fragment and improving sesamoid position. It works best when the primary problem is a deformity of the first ray itself that can be corrected without altering the rest of the forefoot. In metatarsus adductus, the issue is inwardly adducted forefoot overall, not a focal angular deformity of the first metatarsal. A first-ray osteotomy like Evan’s won’t address the broader forefoot adduction and can destabilize the medial column or fail to correct the underlying pattern, making it the wrong choice for this condition. If the forefoot’s adduction is the dominant problem, other approaches that address the entire forefoot alignment are better suited.

Evan’s osteotomy targets the first metatarsal to correct hallux valgus by creating a realignment of the distal fragment and improving sesamoid position. It works best when the primary problem is a deformity of the first ray itself that can be corrected without altering the rest of the forefoot.

In metatarsus adductus, the issue is inwardly adducted forefoot overall, not a focal angular deformity of the first metatarsal. A first-ray osteotomy like Evan’s won’t address the broader forefoot adduction and can destabilize the medial column or fail to correct the underlying pattern, making it the wrong choice for this condition. If the forefoot’s adduction is the dominant problem, other approaches that address the entire forefoot alignment are better suited.