Surgical treatment for bunions in adolescents

The results of three different surgical procedures for the correction of bu nions on 25 adolescent feet (distal soft-tissue procedure, proximal closing -wedge osteotomy of the first metatarsal with distal soft-tissue procedure, and proximal phalangeal osteotomy) are reviewed. The results with an avera ge follow-up of 3.5 years were excellent or good in 21 cases, and fair or p oor in 4. The average correction of the metatarsophalangeal angle, the intermetatarsa l angle, and the hallux valgus interphalangeus angle was, respectively, 9.8 8, 3.11, and 0.0 degrees for the first procedure, 21.0, 6.87, and 0.0 degre es for the second, and 11.0, 0.9, and 22.5 degrees for the third. We conclu de that distal soft-tissue reconstruction allows only mild to moderate corr ection of the metatarsophalangeal and intermetatarsal angles, and the assoc iation of a proximal osteotomy of the first metatarsal produces an statisti cally significant better correction (p < 0.05). Hallux valgus interphalange us deformities are corrected only by proximal. phalanx osteotomies. The sel ection of a particular procedure should therefore be based on an appropriat e preoperative planification.