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Review Question - QID 220266

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QID 220266 (Type "220266" in App Search)
A skeletally mature 15-year-old girl with juvenile hallux valgus presents to your clinic for a second opinion. She has attempted nonoperative management with shoewear modifications and is interested in surgical intervention. She has seen an outside orthopaedic surgeon who has recommended a distal first metatarsal osteotomy. In your discussion with her, you recommend a double first metatarsal osteotomy. Which of the following is considered an indication to perform a double first metatarsal osteotomy to treat juvenile hallux valgus?