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 when the first ray is elevated (metatarsus primus elevatus) and aims to plantarflex or shorten the distal first metatarsal to realign the hallux and reduce pressure transfer to the second metatarsal. In metatarsus adductus, the problem is a transverse forefoot adduction rather than elevation of the first ray. Performing this osteotomy wouldn’t correct the adduction and could destabilize the medial column or worsen overall forefoot alignment. Therefore, this procedure is avoided in metatarsus adductus. It remains more appropriate for hallux valgus with an elevated first ray, while pes planus or metatarsus varus involve different mechanical corrections.