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Hallux varus

Robert Vander Griend
BACKGROUND: Operative correction of a symptomatic hallux valgus interphalangeus (HVI) deformity is often achieved with an osteotomy at the proximal end of the proximal phalanx (Akin osteotomy). However, the apex of the typical HVI deformity (center of rotation angle) is at the interphalangeal joint of the hallux. This study was done to evaluate the results of performing a medial closing wedge osteotomy at the distal end of the proximal phalanx. METHODS: Thirty-three patients (33 feet) underwent an osteotomy at the distal end of the proximal phalanx for correction of HVI...
September 26, 2016: Foot & Ankle International
B Salazard, C Philandrianos, A Gaudeuille
Malformations and deformations of the forefoot are a frequent reason for consultation. The most frequent malformations viewed at birth are syndactylies (second web space), clinodactylies (quintus varus, halllux), polydactylies (hallux, fifth toe). The macrodactylies, hypoplasia, amniotic bands are rare. The management of these defects requires knowledge of surgery adult foot, plastic surgery and especially collaboration with physiotherapists, podiatrists and orthotists. The fast growth of the foot the first year and the development of walking at one year require to start early the treatment of deformations and to anticipate the evolution of malformations...
October 2016: Annales de Chirurgie Plastique et Esthétique
Ryuhei Katsui, Norihiro Samoto, Akira Taniguchi, Manabu Akahane, Shinji Isomoto, Kazuya Sugimoto, Yasuhito Tanaka
BACKGROUND: Although the tangential sesamoid view is used to visualize the sesamoid position relative to the first metatarsal head, correctly evaluating patients with severe varus of the first metatarsal is difficult. Computed tomography (CT) can be helpful due to its cross-sectional images in any plane. The purposes of this study were to evaluate the alignment of the tibial sesamoid and investigate the relationship between malalignment and degenerative change in the sesamoid metatarsal joint (SMJ) using simulated weight-bearing CT imaging in patients with hallux valgus...
August 16, 2016: Foot & Ankle International
A Erdem Bagatur, Mehmet Albayrak, Yunus Emre Akman, Merter Yalcinkaya, Utku Erdem Ozer, Mehmet Burak Yalcin
A simple, inexpensive technique for fixation of proximal opening-wedge osteotomy of the first metatarsal for correction of moderate or severe hallux valgus (HV) is described. After the opening-wedge osteotomy and bone grafting of the first metatarsal have been performed, 2 Kirschner wires are introduced for internal fixation and removed 8 weeks postoperatively. Twenty-three patients with symptomatic HV who had a proximal medial opening-wedge osteotomy of the first metatarsal in combination with a distal soft tissue procedure and bunionectomy were evaluated retrospectively...
July 19, 2016: Orthopedics
R Matthew McKean, Patrick F Bergin, Geoffrey Watson, Siddhant K Mehta, Thom A Tarquinio
BACKGROUND: Arthrodesis is a standard operative treatment for symptomatic arthritis of the first metatarsophalangeal (MTP) joint. Patients with degenerative joint disease (DJD), severe hallux valgus, and metatarsus primus varus may also require fusion of the first MTP joint. An important question in the latter group of patients is whether a proximal first metatarsal osteotomy is required, in addition to the first MTP joint fusion. Our hypothesis was that patients with severe hallux valgus and metatarsus primus varus, treated with first MTP joint arthrodesis alone, would have correction of the first-to-second intermetatarsal angle (1-2 IMA) and hallux valgus angle (HVA) to near population norms, without the addition of a proximal first metatarsal osteotomy...
July 11, 2016: Foot & Ankle International
Makoto Hirao, Yukio Hirai, Kosuke Ebina, Kenrin Shi, Takaaki Noguchi, Hideki Tsuboi, Jun Hashimoto, Hideki Yoshikawa
Hallux valgus (HV) deformity is associated with hindfoot valgus deformity. We experienced a case that suggests the possibility that valgus correction for varus hindfoot with bony ankylosis of the subtalar joint by total ankle arthroplasty may have caused a forefoot HV deformity, despite adequate valgus correction.
May 4, 2016: Modern Rheumatology
Hong-liang Li, Shu-yuan Li, Wei Qi, Chun-bao Li, Feng Qu, Guo Qi, Gang Zhao, Yu-jie Liu, Juan-li Zhu
OBJECTIVE: To evaluate the effect of arthroscopy-assisted minimally invasive management of bunion and hallux valgus deformities. METHODS: Total 50 patients (53 feet) with bunion and hallux valgus deformities were treated under arthroscopy from July 2008 to July 2011, with an average age of 42.3 years old (ranging from 30 to 65 years old) involving 19 left feet, 28 right feet and 3 both feet. The American Orthopedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal(MP-IP) Scale Score was used to evaluate the therapeutic effect...
February 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Alberto Ginés-Cespedosa, Daniel Pérez-Prieto, David Muñetón, Gemma González-Lucena, Angelica Millán, Santiago de Zabala, Rosa Busquets
BACKGROUND: Hindfoot deformity has been described as a risk factor for poor hallux valgus (HV) surgery outcomes. However, there has been no study that demonstrates it. The purpose of this investigation was to evaluate the influence of hindfoot misalignment in HV surgery results. METHODS: All patients operated on for HV during 2010 and 2011 at 3 university hospitals were included. The preoperative and 2-year postoperative radiologic data included the HV and the intermetatarsal (IM) angles, the naviculocuboid overlap (NC), the talonavicular coverage (TN) angle, the talus-first metatarsal (T-1MT) angle, as well as the calcaneal pitch (CP) angle...
August 2016: Foot & Ankle International
Nicolas Arcuri, Tzvi Bar-David, Simcha Pollack
We reviewed 33 consecutive Mau-Reverdin osteotomies in 23 patients performed for correction of hallux abducto valgus from November 2010 to May 2013. All patients were followed up and evaluated for a mean of 401 days and median of 360 days after surgery. In each foot, the preoperative first intermetatarsal angle, hallux abductus angle, and proximal articular set angle were obtained. The mean correction of these angles was as follows: intermetatarsal angle 10.5° ± 3.31°, hallux abductus angle 24.4° ± 8...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Rami Oravakangas, Juhana Leppilahti, Vesa Laine, Tuukka Niinimäki
Hallux valgus is one of the most common foot deformities. Proximal opening wedge osteotomy is used for the treatment of moderate and severe hallux valgus with metatarsus primus varus. However, hypermobility of the first tarsometatarsal joint can compromise the results of the operation, and a paucity of midterm results are available regarding proximal open wedge osteotomy surgery. The aim of the present study was to assess the midterm results of proximal open wedge osteotomy in a consecutive series of patients with severe hallux valgus...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
José M Castillo-López, Pedro V Munuera-Martínez, Cristina Algaba-Guisado, María Reina-Bueno, Nadia Salti-Pozo, Alfonso Vargas-Macías
BACKGROUND: The foot is the main element of artistic creation in flamenco dancing. At the professional level, the foot undergoes high musculoskeletal demands, predisposing the development of podiatric pathologic disorders in this group. The principal objective of this study was to determine the most common foot lesions in professional female flamenco dancers. METHODS: In a cross-sectional observational study of 44 female professional flamenco dancers, the participants completed a short questionnaire about their demographic features, number of hours danced per week, and years of professional activity...
January 2016: Journal of the American Podiatric Medical Association
Brian P Gradisek, Lowell Weil
Hallux varus is an infrequently encountered deformity of the first ray characterized by a medial deviation of the hallux on the first metatarsal head at the first metatarsal phalangeal joint. Iatrogenic flexible hallux varus often requires surgical repair to create a functional, pain-free, shoeable foot. Although arthrodesis remains the mainstay of treatment, many soft tissue transfer procedures have been described in the literature as joint-sparing alternatives to fusion. This article explores in detail the tendon transfer procedures that have been described for repair of flexible hallux varus deformity...
January 2016: Clinics in Podiatric Medicine and Surgery
Paul Dayton, Merrell Kauwe, Lawrence DiDomenico, Mindi Feilmeier, Rachel Reimer
The data from 35 consecutive patients with hallux valgus undergoing triplane arthrodesis at the first tarsal metatarsal joint were studied to determine the amount of first metatarsal frontal plane rotation (supination) needed to anatomically align the first metatarsal phalangeal joint on an anterior posterior radiograph without soft tissue balancing at the first metatarsal phalangeal joint. Radiographs were measured both pre- and postoperatively to assess the 1-2 intermetatarsal angle, hallux abductus angle, and tibial sesamoid position (TSP)...
March 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Xingchao Yan, Jianfeng Liu, Bin Liu, Zhigang Liu, Yuehai Pan, Xiaoyan Jia, Yanan Zhang, Jiangbo Shao
OBJECTIVE: To explore the effectiveness of the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons in correcting hallux valgus. METHODS: A retrospective analysis was made on the clinical data from 28 patients (40 feet) with hallux valgus treated with the procedure of reconstructing the transverse arch of the forefoot by anastomosing adductor hallucis and abductor hallucis tendons between January 2010 and January 2014...
April 2015: Chinese Journal of Reparative and Reconstructive Surgery
Tun Hing Lui
Arthroscopic first metatarsophalangeal arthrodesis for fixed hallux varus deformity can be very difficult because narrowing of the medial joint space results in difficult access. The abductor hallucis tendon and the medial capsule can be released through a small proximal plantar medial incision. This will convert the deformity into a flexible one and open up the medial joint space. This allows arthroscopic arthrodesis using the standard dorsolateral and medial portals. The plantar medial incision can also be used for arthroscopy of the metatarsosesamoid compartment and insertion of a screw for first metatarsophalangeal arthrodesis...
November 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
F Dalat, F Cottalorda, M-H Fessy, J-L Besse
INTRODUCTION: First-ray metatarsophalangeal arthrodesis is a classic surgical procedure in the treatment of severe hallux valgus, hallux rigidus, revision surgery, and inflammatory arthritis. The objective of this study was to verify if metatarsophalangeal plate arthrodesis could correct the M1M2 intermetatarsal angle. MATERIAL AND METHODS: This prospective and continuous series (June 2007 to March 2011) included 208 patients (48% severe and/or arthritic hallux valgus, 18% hallux rigidus, 16% rheumatoid forefoot, 13% surgical revision of the first ray, 5% hallux varus), with a mean age of 62...
October 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
Matthew J Boyle, Grant D Hogue, James R Kasser
BACKGROUND: Polydactyly of the foot is a relatively common condition. Approximately 15% of cases are preaxial, with one third of these cases involving duplication of the metatarsal [metatarsal type preaxial polydactyly (MTPP)].Surgical reconstruction of polydactyly is indicated to improve shoe tolerance. Reconstruction of MTPP has traditionally involved resection of the hypoplastic lateral ray in addition to soft tissue reconstruction to correct hallux varus. Poor postoperative results have frequently been reported, primarily due to residual hallux varus...
September 2016: Journal of Pediatric Orthopedics
D Arbab, C Wingenfeld, D Frank, B Bouillon, D P König
OBJECTIVE: Distal, lateral soft tissue release to restore mediolateral balance of the first metatarsophalangeal (MTP) joint in hallux valgus deformity. Incision of the adductor hallucis tendon from the fibular sesamoid, the lateral capsule, the lateral collateral ligament, and the lateral metatarsosesamoid ligament. INDICATIONS: Hallux valgus deformities or recurrent hallux valgus deformities with an incongruent MTP joint. CONTRAINDICATIONS: General medical contraindications to surgical interventions...
April 2016: Operative Orthopädie und Traumatologie
Tun Hing Lui
Idiopathic adult hallux varus is a rare deformity. In this report, I present a technique for correction of this condition by extensor hallucis longus tenodesis and extensor digitorum brevis transfer.
November 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Mehmet Erdil, Hasan Huseyin Ceylan, Gokhan Polat, Deniz Kara, Ergun Bozdag, Emin Sunbuloglu
Proximal metatarsal osteotomy is the most effective technique for correcting hallux valgus deformities, especially in metatarsus primus varus. However, these surgeries are technically demanding and prone to complications, such as nonunion, implant failure, and unexpected extension of the osteotomy to the tarsometatarsal joint. In a preclinical study, we evaluated the biomechanical properties of the fixator and compared it with compression screws for treating hallux valgus with a proximal metatarsal osteotomy...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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