All patients with
cerebral palsy who had
hallux valgus and
bunion deformities surgically corrected between 1986 and 1995 were reviewed to determine whether techniques other than
arthrodesis of the first metatarsophalangeal joint would adequately correct these
deformities. Twenty-six feet of 17 patients were surgically corrected for their
bunions and/or their
hallux valgus deformity. The mean
hallux valgus angle for all children was 30 degrees, preoperatively, with 70% correction achieved. Four techniques of surgical correction were used. A first metatarsophalangeal joint
arthrodesis on eight feet gave excellent outcomes for all using the duPont
Bunion Rating Score and a mean of 89% correction of the
hallux valgus angle. A proximal first metatarsal
osteotomy, distal soft tissue release, and exostectomy of the
bunion on five feet gave three excellent and two fair outcomes, with a mean of 83% correction of the
hallux valgus angle. A distal soft tissue release and exostectomy on eight feet gave four excellent outcomes, two good outcomes, and two fair outcomes, with a mean of 53% correction of the
hallux valgus angle. An
osteotomy of the first proximal phalanx, metatarosphalageal soft tissue release, and exostectomy on five feet gave three excellent outcomes, one good outcome, and one fair outcome with a mean of 36% correction of the
hallux valgus angle. All patients who met the criteria for the procedures were satisfied with the outcomes; however, the first metatarosphalageal joint
arthrodesis gave the best results with the highest percent correction and
bunion score.