ArticleFoot & ankle international2026
Effect of the Reverse Cotton Osteotomy on First Metatarsal Position: A Cadaveric Study.
Article in Foot & ankle international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFlatfoot deformities are characterized by collapse of the medial arch due to tendinous and ligamentous dysfunction. The degree of deformity can be evaluated radiographically by measuring the talo-first metatarsal angle (Meary angle). These deformities have traditionally been corrected using a medial cuneiform dorsal opening wedge (Cotton) osteotomy; however, this procedure requires bone grafting to fill the osteotomy site and results in lengthening of the medial column. To address these concerns, the plantar closing wedge of the medial cuneiform bone, known as the reverse Cotton osteotomy (RCO), was developed. In this study, we aim to determine the effect of the RCO on the position of the first metatarsal, thus providing guidance and recommendations for surgeons employing the reverse Cotton osteotomy in the correction of adult-acquired flatfoot.
methodsIn this cadaveric study, we characterized the mean angular correction achieved by 1-, 2-, 3-, and 4-mm RCO by radiographically measuring Meary angle under simulated weight-bearing conditions. Secondary outcomes included radiographic measurements of the navicular-cuneiform incongruency angle (NCIA) and calcaneal pitch angle.
resultsStatistically significant increases in Meary angle were observed following 1-mm (
conclusionThe RCO was associated with significant ( CLINICAL RELEVANCE: The findings of this study can guide surgeons performing RCO to correct flatfoot deformities, thereby potentially contributing to improved postoperative outcomes.
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