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Selected Instructional Course Lecture   |    
Surgical Correction of Moderate and Severe Hallux ValgusProximal Metatarsal Osteotomy with Distal Soft-Tissue Correction and Arthrodesis of the Metatarsophalangeal Joint
V. James Sammarco, MD1
1 V. James Sammarco, MD Cincinnati Sportsmedicine and Orthopaedic Center, 10663 Montgomery Road, Cincinnati, OH 45242. E-mail address: vjsammarco@csmoc.com
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Disclosure: The author did not receive any outside funding or grants in support of his research for or preparation of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the author, or a member of his immediate family, is affiliated or associated.
Printed with permission of the American Academy of Orthopaedic Surgeons. This article, as well as other lectures presented at the Academy's Annual Meeting, will be available in March 2008 in Instructional Course Lectures, Volume 57. The complete volume can be ordered online at www.aaos.org, or by calling 800-626-6726 (8 a.m.-5 p.m., Central time).
An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Nov 01;89(11):2520-2531
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Extract

The painful bunion deformity is a common and relatively disabling condition that affects individuals of all ages. More than 150 procedures have been described for the treatment of hallux valgus, and the orthopaedic literature has focused predominantly on surgical management of this condition; however, successful treatment is often achieved with use of simple off-the-shelf orthotic devices and appropriate shoe-wear modifications. Given the potential for surgical complications, the substantial recovery period associated with bunion surgery, and patients' occasional dissatisfaction with the results of otherwise technically successful procedures, it is recommended that nonoperative treatment be initiated prior to proceeding with surgery. It is not uncommon for a patient with an asymptomatic bunion to actively seek surgical correction because of cosmetic concerns or because of an inability to wear fashionable shoes comfortably. While pain alone is not the only indication for surgery, it is not recommended that surgery be performed for cosmetic reasons alone. The American Orthopaedic Foot and Ankle Society has issued a position statement reflecting this1.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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