Robinson and Limbers review the full treatment landscape for hallux valgus — from aetiology and radiological assessment through the complete menu of osteotomies, soft-tissue procedures, and arthrodeses — asking which technique best matches a given deformity pattern and why so many operations exist.
When planning hallux valgus surgery, match the procedure to the IMA: Chevron for mild deformity (IMA <14°), scarf for moderate (IMA 14–20°), and proximal osteotomy or fusion for severe (IMA >20°); if first tarsometatarsal hypermobility is present (>9 mm sagittal excursion), consider Lapidus fusion over osteotomy alone.
Always counsel patients that only 60% achieve unrestricted footwear, and avoid Keller's arthroplasty in any patient with meaningful functional demands.
Robinson and Limbers review the full treatment landscape for hallux valgus — from aetiology and radiological assessment through the complete menu of osteotomies, soft-tissue procedures, and arthrodeses — asking which technique best matches a given deformity pattern and why so many operations exist.
When planning hallux valgus surgery, match the procedure to the IMA: Chevron for mild deformity (IMA <14°), scarf for moderate (IMA 14–20°), and proximal osteotomy or fusion for severe (IMA >20°); if first tarsometatarsal hypermobility is present (>9 mm sagittal excursion), consider Lapidus fusion over osteotomy alone.
Always counsel patients that only 60% achieve unrestricted footwear, and avoid Keller's arthroplasty in any patient with meaningful functional demands.