87 patients (101 feet) aged 16 to 63 years, suffering from hallux valgus were randomized to evaluate the efficacy of the Lapidus procedure against the Hohmann procedure for long-term results, and to assess the implications of a hypermobile first tarsometatarsal joint (TMTJ-1). Hypermobility of the TMTJ-1, pain, function, measurement of the hallux valgus angle and forefoot, as well as patient satisfaction were all collected from randomized patients and evaluated over 8 to 11 years. The evidence indicates that the two treatments are comparable for long-term hallux vallgus outcomes, and that the presence or absence of a hypermobile first tarsometatarsal joint (TMTJ-1) made no differences to these outcomes.