CPT® Code 28306

An osteotomy of the first metatarsal, as described by CPT® Code 28306, involves surgical intervention to correct angular deformities of the foot. This procedure can be performed with or without additional techniques such as lengthening, shortening, or angular correction of the metatarsal bone. The first metatarsal is a critical bone in the foot, and its alignment is essential for proper foot function. Conditions that may necessitate this procedure include acquired or congenital deformities like hallux valgus (commonly known as bunions), metatarsus primus varus, hallux varus, and dorsal bunions. During the procedure, the surgeon exposes the first metatarsal, which may involve incising the metatarsophalangeal (MTP) joint capsule and dividing tendons as necessary to gain access to the bone. Depending on the specific deformity being addressed, the osteotomy may require excision that extends to the proximal phalanx and/or the medial cuneiform bones. The technique employed can vary; for instance, a closing wedge osteotomy involves cutting the metatarsal and removing a wedge of bone to realign the structure, while an opening wedge osteotomy entails cutting the bone and using a laminar spreader to create space for alignment, often accompanied by the placement of a bone graft. The choice of technique and whether to use a bone autograft depends on the specific clinical scenario and the surgeon's discretion.