Hallux valgus deformity is radiographically quantified by two angles. The normal intermetatarsal angle (IMA) between the first and second metatarsals is <9°. A 30-year-old woman has an IMA of 18° and a hallux valgus angle of 38°. This magnitude of deformity is best corrected surgically by:

• A First tarsometatarsal (Lapidus) arthrodesis ✓
• B McBride (soft tissue) bunionectomy alone
• C Chevron (Austin) osteotomy of the first metatarsal head
• D Scarf osteotomy or Ludloff metatarsal shaft osteotomy

Explanation

Surgical correction of hallux valgus is matched to the severity of the IMA. Chevron osteotomy corrects IMA increases of up to ~6° and is used for mild-moderate deformity (IMA 9–14°). Scarf and Ludloff shaft osteotomies correct moderate deformity (IMA 14–18°). For severe deformity (IMA >18°) or when hypermobility of the first tarsometatarsal joint is present, Lapidus arthrodesis (fusion of the first TMT joint with realignment) provides the most durable correction and is the procedure of choice.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.