More than 130 operations have been described for the treatment of hallux valgus. The plethora of techniques indicates that no single operation is perfect, and none will address all cases. Treatment which is poorly planned or executed leads to high levels of patient dissatisfaction. In recent years, a number of new osteotomies have been described. Determining which to use can be difficult. This review will examine the important factors in choosing the most appropriate techniques.

Surgery for hallux valgus, while technically demanding, has a high rate of success in appropriately selected patients. However, a small number of patients have poor outcomes following operation. Randomised, controlled trials are needed to elucidate the factors which determine a good outcome. There is also a need for a good validated outcome score.