The indication for surgery is pain which is not adequately controlled by non-operative means or difficulty of shoe wear not responding to orthoses. A thorough understanding of patient goals and the mechanical influences contributing to HV deformity are necessary factors in determining the correct procedure in each individual. There is no procedure that can successfully apply to all deformities. Most procedures for correction of HV do work if properly performed in the right indications. Surgical options include: MTPJ soft-tissue reconstruction, osteotomy (of the proximal phalanx of the great toe, of the first metatarsal bone or of the cuneiform), arthrodesis (of the first MTPJ or of MTCJ) and arthroplasty (exisional or implant).