Revision surgery of the first ray.

When dealing with the first ray, and in particular when preparing for hallux abductovalgus surgery, numerous guidelines are available to help decide what procedure is most appropriate for the pathology based on radiographic findings. However, these guidelines are not as black and white as some physicians may think. Numerous factors affect the selection of a procedure, including physician preference, physician comfort with a procedure, experience with a procedure, and surgical skills. This article takes a clinical look at a number of complications related to surgery and trauma of the first ray, and presents a critical discussion of the thought process used to address the complication.