Mann and Coughlin review the anatomy, biomechanical progression, and surgical management of hallux valgus, with detailed description of the modified McBride soft-tissue procedure. Using 100 consecutive operative cases, the paper defines the correction achievable without osteotomy and establishes thresholds for when bony procedures must be added.
When planning hallux valgus correction, use the 40°/15° rule: if the hallux valgus angle exceeds 40° or the intermetatarsal angle exceeds 15°, a soft-tissue procedure alone will be insufficient and a first metatarsal osteotomy must be added.
Intraoperatively, avoid overcorrecting severe deformities — the 11% hallux varus rate in this series was concentrated in exactly those cases.
Mann and Coughlin review the anatomy, biomechanical progression, and surgical management of hallux valgus, with detailed description of the modified McBride soft-tissue procedure. Using 100 consecutive operative cases, the paper defines the correction achievable without osteotomy and establishes thresholds for when bony procedures must be added.
When planning hallux valgus correction, use the 40°/15° rule: if the hallux valgus angle exceeds 40° or the intermetatarsal angle exceeds 15°, a soft-tissue procedure alone will be insufficient and a first metatarsal osteotomy must be added.
Intraoperatively, avoid overcorrecting severe deformities — the 11% hallux varus rate in this series was concentrated in exactly those cases.