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J Foot Ankle Surg. 2018 Sep - Oct;57(5):972-981. doi: 10.1053/j.jfas.2018.02.008. Epub 2018 May 18.

Triplane Hallux Abducto Valgus Classification.

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Surgical Director, Northern Colorado Podiatric Medicine & Surgery Residency, Greeley, CO; Clinical Instructor, Dr William M Scholl College of Podiatric Medicine, North Chicago, IL. Electronic address:
Assistant Professor and Chief of Foot & Ankle Surgery, Department of Orthopaedics, West Virginia University School of Medicine, Morgantown, WV.
Director, Foot & Ankle Division, Palmetto Health-USC Orthopedic Center, Columbia, SC; Assistant Professor, Orthopedics, University of South Carolina, Columbia, SC.
Attending Staff, UnityPoint Clinic, Fort Dodge, IA; Assistant Professor, College of Podiatric Medicine and Surgery, Des Moines University, Des Moines, IA.
President and Fellowship Director, Weil Foot and Ankle Institute, Des Plaines, IL.


One of the most common procedures performed in the foot and ankle is correction of hallux abducto valgus deformity or "bunion surgery." Most foot and ankle surgeons recognize the challenges associated with defining each patient's individual deformity and selecting the optimal procedure for the best long-term results. Using current 2-dimensional algorithms that focus on the severity of the transverse plane deformity, surgical outcomes have varied. In the past 10 years, high recurrence and complication rates for popular procedures have been reported. In the same period, the reported data have elucidated an evolving anatomic understanding of the bunion deformity, with an expansion to 3 dimensions, including the frontal/coronal plane. We present a new classification and approach for the evaluation and procedure selection for bunion surgery. We hope this conceptual treatise on hallux abducto valgus based on clinical consensus and current data will stimulate academic discussion and further research. This anatomic classification is based on the 3-dimensional anatomy of the first ray.


3-dimensional; CORA; bunion correction; first metatarsal; frontal plane rotation; hallux abducto valgus; hallux valgus


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