Rotational and opening wedge basal osteotomies.

There are more than 150 different procedures described for correction of the hallux valgus deformity, the treatment of which is usually guided by severity. Moderate to severe hallux valgus has traditionally been managed with a shaft or proximal osteotomy together with distal soft-tissue release. Proximal osteotomies can be classified as translation or rotational. Rotational osteotomies such as the Ludloff and proximal opening wedge have not been popular historically because of instability from lack of fixation, resulting in complications. This article describes modified techniques with modern fixation of these 2 osteotomies, which offer stable fixation and reproducible results.