Early results of the modified Peterson bunion procedure for adolescent hallux valgus

Adolescent hallux valgus has a high recurrence rate after conventional surgical corrections. Excellent results have been reported with a double osteotomy of the first metatarsal fixed with a 3/16" transarticular pin. The present study reports the early results of using a medial plate and screws with an osteoperiosteal distally based flap to correct metatarsophalangeal joint subluxation, decrease recurrence from laxity in the medial capsular repair, and avoid intra-articular damage. The study included 18 feet in 16 patients (8 males, 8 females). All osteotomies healed primarily without complications, though there was recurrence in 3 undercorrected feet (2 patients). The average preoperative hallux valgus angle of 34 degrees was reduced to 16 degrees at a minimum 1-year follow-up. The average intermetatarsal angle improved from 14 degrees (before operation) to 6 degrees. No patient has requested plate removal.