Modified McBride's procedure: long-term results.

This paper presents the long-term results of using a modified version of McBride's procedure for the treatment of hallux valgus. The operation used in this group of patients is that described by McBride where the adductor hallucis tendon is detached from the base of the proximal phalanx. Our modification has been to augment this with a medial capsular reef, the adductor tendon is taken through a hole in the metatarsal neck and attached to the medial capsule. We did not remove the sesamoid bone. Twenty-nine feet have been followed up for up to 12 years and the results graded using Bonney and MacNab's scoring system. In a group of women aged 51-71 years 93% still have a satisfactory result up to 12 years after their operation. This operation would appear to be a reasonable option in the treatment of hallux valgus in patients with significant pain and deformity as long as they do not have major arthritic changes in the first metatarsophalangeal joint.