Level III, retrospective comparative case series.

Level III, retrospective cohort study.

A proximal crescentic osteotomy of the first metatarsal combined with distal soft-tissue realignment should be considered in the surgical management of moderate and severe subluxated hallux valgus deformities. First ray mobility was routinely reduced to a normal level without the need for an arthrodesis of the metatarsocuneiform joint. Plantar gapping is not a reliable radiographic indication of hypermobility of the first ray in the sagittal plane.

In the present study, arthrodesis of the first MTP joint for idiopathic hallux valgus resulted in a high percentage of successful results at an average followup of over 8 years.

We believe the progress of the fusion cannot be determined accurately from standard radiographs. CT scanning appears to be significantly more reliable. The concept of what constitutes an adequate fusion deserves more extensive study.