Advanced hallux valgus deformity: long-term results utilizing the distal soft tissue procedure and proximal metatarsal osteotomy.

A series of 28 cases with a moderate to severe hallux valgus deformity and intermetatarsal angle of 14 degrees or greater was followed an average of 5 1/2 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 degrees (7-20 degrees), and the average loss of correction was 1.4 degrees; the average correction of the hallux valgus angle was 26.7 degrees (-2 degrees to 48 degrees), and the average loss of correction was 3.8 degrees. 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 degrees 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.