Hallux valgus correction with proximal metatarsal osteotomy: two-year follow-up

We evaluated the results of 33 feet in 23 patients who underwent a basilar crescentic osteotomy with a modified McBride procedure with a minimum 24-month follow-up. The average hallux valgus improved from 37.5 degrees to 13.8 degrees and the intermetatarsal 1-2 angle from 14.9 degrees to 4.7 degrees. The angle of declination of the first metatarsal was found to have dorsiflexed an average of 6.2 degrees. Unfortunately, osteotomies secured with staples dorsiflexed to a greater degree. Bilateral foot surgery produced results similar to those with unilateral procedures. Four of our patients developed a hallux varus (range 2-8 degrees); however, none were dissatisfied at the time of evaluation. Although this bunion procedure resulted in more prolonged swelling and pain than a distal osteotomy, it should be considered for more complex deformities to avoid the failure that a distal metatarsal osteotomy might produce given a high 1-2 intermetatarsal angle or a high hallux valgus angle.