title: Surgical correction of moderate and severe hallux valgus: proximal metatarsal osteotomy with distal soft-tissue correction and arthrodesis of the metatarsophalangeal joint.
abstract: Hallux valgus correction by distal soft-tissue release and proximal metatarsal osteotomy is the procedure of choice for most patients with moderate and severe hallux valgus deformity. Complications can be avoided by selecting a procedure that provides adequate correction of the intermetatarsal angle and ensuring proper balancing of the metatarsophalangeal joint though lateral soft-tissue releases and medial joint plication. Arthrodesis should be considered when revision of failed surgery is planned, degenerative joint disease is present, and where the likelihood of failure of a bunion procedure is high (such as in elderly individuals with osteoporosis, severe deformity with significant involvement of the lesser metatarsophalangeal joint, and when spasticity is present). A review of biomechanical data, clinical studies, and surgical techniques is important for successful treatment of moderate and severe hallux valgus deformity.
authors.affiliation: Cincinnati Sports Medicine and Orthopaedic Center, Cincinnati, Ohio, USA.
authors.forename: V James
authors.initials: VJ
authors.lastname: Sammarco
mesh_terms: D001174:Arthrodesis / Q000379:methods*; D006215:Hallux Valgus / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008682:Metatarsal Bones / Q000601:surgery*; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D012720:Severity of Illness Index