Adolescent bunions treated by the modified Lapidus procedure.

The modified Lapidus procedure with rigid internal fixation was used to correct adolescent bunion deformities in 20 patients (32 feet). All patients were female and skeletally mature at surgery. Their average age was 18 years. Preoperatively, 100% had bunion pain and trouble with shoe wear, and 93% had a hypermobile first ray. Sixteen patients (24 feet) were available for follow-up examination and radiographs. The average follow-up time for the entire group was 24.3 months (range 3-72 months). Excellent or good results were obtained in 91% of patients. One recurrence required reoperation with first metatarsal osteotomy and MTP joint debridement. In our experience, the modified Lapidus procedure is the procedure of choice for the adolescent bunion with a hypermobile first ray.