Evaluation and operative procedures for hallux valgus deformity

The hallux valgus deformity, or bunion deformity, is a common problem. Evaluation of the deformity for surgical intervention requires a knowledge of the basic pathomechanics of the medial displacement of the head out of the sesamoid complex with the associated deformity of the large toe and incompetency of the metatarsal cuneiform joint. The foot's relation to the leg and the body must be evaluated as well as the general condition of the patient, the age of the patient, and the expectations of the patient in regard to footwear and level of activity desired postoperatively. X-rays of the feet must be made in a consistent manner. The deformity should be classified as to the degree of severity. Operative procedures are grouped into the distal soft tissue procedures, metatarsal osteotomies, miscellaneous procedures, arthroplasty operations, and combinations of procedures. Indications and complications are presented. The procedures are discussed to provide an overview of surgical methods of treatment available for the hallux valgus deformity.