Advanced Hallux Valgus Deformity: Long-Term Results Utilizing the Distal Soft Tissue Procedure and Proximal Metatarsal Osteotomy

Abstract

A series of 28 cases with a moderate to severe hallux valgus deformity and intermetatarsal angle of 14° or greater was followed an average of 5½ years to determine whether any significant loss of correction occurred. All feet were treated with a distal soft tissue procedure and proximal metatarsal osteotomy. The average correction of the intermetatarsal angle was 13.2° (7–20°), and the average loss of correction was 1.4°; the average correction of the hallux valgus angle was 26.7° (−2° to 48°), and the average loss of correction was 3.8°. In three cases, a recurrent deformity developed; in three other cases, a hallux varus deformity developed, two of which were symptomatic. Patient satisfaction was 85%. This study indicates that in most patients with a hallux valgus deformity and an intermetatarsal angle of 14° or greater, there is sufficient inherent stability of the first metatarsocuneiform joint that it does not require stabilization to obtain a satisfactory long-term result.