A review of surgical procedures for hallux valgus.

One hundred seventy-two patients who underwent surgical correction of hallux valgus deformity were evaluated. The procedures chosen were: first metatarsal osteotomy in 96, Keller procedure in 42, metatarsophalangeal arthrodesis in 25, and simple bunionectomy in 9. This study allowed the establishment of the following guidelines for surgery. 1) Osteotomy alone yields a satisfactory result in patients under the age of 50 years who have minimal osteoarthritis of the metatarsophalangeal joint. 2) The Keller procedure is suggested in patients over the age of 50 who have significant osteoarthritis. 3) Metatarsophalangeal fusion is suggested in patients under the age of 50 with significant osteoarthritis. 4) Simple bunionectomy revealed poor results in the majority of patients. It should be reserved for the elderly patient with an infected bunion.