130 adult females undergoing distal chevron osteotomy as part of a distal soft-tissue procedure for the treatment of symptomatic unilateral hallux valgus were randomized to compare 2 surgical techniques: the dorsal first web-space approach and the medial transarticular approach. Patients were assessed over 38 months and the evidence presented in this study revealed no clinical or radiographic outcome differences between the dorsal first web-space approach and the medial transarticular approach in terms of the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale, patient satisfaction, or radiographic outcomes.