Distal metatarsal osteotomies aim to replace the 1st MT head over the sesamoids by moving it laterally. Provided the head can be moved laterally enough without it becoming unstable, this can usually be achieved
A medial-based wedge allows correction of DMAA
Distal osteotomies are simple and quick to do. Their main disadvantage is that they may not be able to move the MT head far enough laterally to realign the first ray adequately.