Figure 1.

Representative case of a 75-year-old woman with a 40-year history of RA. (a) Preoperative radiograph with weight-bearing. Severe hallux valgus deformity, subluxation/dislocation of the lesser toe MTP joints, and joint erosion are seen. (b) Postoperative radiograph with weight-bearing 7 years after surgery. Combination surgery of modified scarf osteotomy and metatarsal shortening offset osteotomy has been performed. Akin osteotomy was also added to control the rotation and alignment. Painful callosity disappeared, and correction has been maintained 7 years after surgery. She can run at present.