The primary deformity in hallux valgus and metatarsus primus varus.

Analysis of radiographs from patients with hallux valgus showed that following surgical correction there were statistically significant reductions in the hallux valgus, intermetatarsal, and metatarsus primus varus angles. Normal values for these angles were established from a control group of asymptomatic feet and from previously published reviews. If the metatarsus primus varus deformity returns to normal following correction of the hallux valgus by a procedure that does not directly realign the metatarsal, the deformity must be secondary to hallux valgus. This is of importance in planning surgical procedures for the correction of these deformities and confirms the relative popularity and success of distal metatarsal osteotomies. Any operation designed to correct both hallux valgus and metatarsus primus varus must aim to correct the primary hallux valgus lesion rather than the secondary metatarsal deviation.