Hallux varus

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The operation of Hawkins, Mitchell and Hedrick for the correction of metatarsus primus varus, bunion, and hallux valgus provides an eminently satisfactory solution both functionally and cosmetically. The procedure is applicable to any degree of deformity. Gratifying results were obtained in 43 operations on 25 patients.

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In hallux valgus surgery, the presence of metatarsus adductus complicates the evaluation of the first-second intermetatarsal angle(IMA) because it will produce an apparent reduction in the IMA because the second metatarsal is skewed closer to the first metatarsal. This can lead to an underestimation of how much the IMA should be reduced. The Kilmartin angle is a simple charting technique that will eliminate the influence of metatarsus adductus and indicate the true degree of metatarsus primus varus. This may facilitate better preoperative planning in hallux valgus surgery...

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Sesamoidectomy of the first metatarsophalangeal joint in athletically active patients may be indicated in cases of chronic sesamoiditis resistant to nonsurgical care or symptomatic displaced fractures or nonunion. Painful scar, hallux deviation, and delayed return to activity are all potential complications. These need to be considered especially when performing surgery in the athletically active individual. Twenty-six sesamoidectomies in 24 patients (21 females and 3 males) were reviewed for type of sesamoidectomy, incision location, time to return to activity, and complications...

We collected high-resolution plantar pressure distributions of seven bonobos during terrestrial bipedal and quadrupedal locomotion (N = 146). Functional foot length, degree of hallux abduction, and total contact time were determined, and plots, showing pressure as a function of time for six different foot regions, were generated. We also studied five adult humans for comparison (N = 13). Both locomotion types of the bonobo show a large variation in plantar pressure distributions, which could be due to the interference of instantaneous behavior with locomotion and differences in walking speed and body dimensions...

OBJECTIVES: We evaluated the short-term results of a combination of distal soft tissue procedure and a modification of proximal crescentic osteotomy, namely, proximal oblique crescentic osteotomy (POCO) in moderate to severe hallux valgus. METHODS: Twenty-five male patients (mean age 21 years; range 19 to 26 years) with moderate to severe hallux valgus and incongruent joint were treated by the distal soft tissue procedure and POCO. Objective evaluations included the hallux valgus angle, the intermetatarsal angle, shortening of the first metatarsal bone, and angulation at the osteotomy site on weight-bearing anteroposterior and lateral radiographs of the foot obtained before surgery and for final examinations...

Ideally, osteotomy for hallux valgus deformities corrects varus angle and pronation, while minimizing elevation, depression, and shortening. We used a serial linkage tracking device to evaluate five variations of the Ludloff osteotomy, a stable proximal metatarsal osteotomy that incorporates an oblique dorsal to plantar cut and a lateral swing or pivoting correction of the dorsal fragment. A neutral osteotomy (perpendicular to the sagittal plane) yielded the greatest correction (14 degrees) but with shortening (average, 2...

HYPOTHESIS/PURPOSE: The Scarf osteotomy has gained popularity as treatment of choice in parts of Europe and is based on sound structural principles. The excellent results reported by others could not, however, be reproduced by the author and the results are presented. METHODS: From January 1997 to June 1997 the Scarf osteotomy was selected in 20 consecutive patients (12 female and eight male patients, ages 18 to 60, mean: 41 years) with moderate metatarsus primus varus (IMA 13 to 20 degrees) and hallux valgus deformities (less than 40 degrees)...

BACKGROUND: Recurrent hallux valgus is a relatively common, yet challenging, condition for both the patient and the surgeon. The literature on the treatment of recurrent hallux valgus is sparse. The purpose of this study was to evaluate prospectively the functional outcome and patient satisfaction following the Lapidus procedure for the treatment of recurrent hallux valgus deformity. METHODS: Twenty-four patients with a total of twenty-six symptomatic recurrences of hallux valgus after previous procedures for treatment of the deformity were included in the study...

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A case report is presented regarding a patient with type IV bilateral ectrodactyly treated with a double surgical approach: in forefoot to correct the malformation and in rearfoot to prevent secondary deformity of the subtalar joint. The forefoot was enlarged and in particular the second and third rays were absent. There was also a metatarsus primus varus with interphalangeal hallux abductus. The second cuneiform bone was removed with a wedge resection of the midfoot. The reduction in transverse diameter of the forefoot was obtained by cerclage of the first and fourth metatarsal bones...

Hallux valgus (HV) is a static subluxation of the first metatarsophalangeal joint with lateral deviation of the great toe and medial deviation of the first metatarsal. Our aim was to evaluate the interference of HV deformity with changes in lumbar lordosis and some foot deformities. Twenty HV patients and 20 healthy subjects were selected for the study. Hallux valgus angle, metatarsus primus varus (MPV), metatarsus omnis varus (MOV), first intermetatarsal (1.IMT), second metatarsal (2. MT) and hallux interphalangeal (HIP) angles were estimated from the anteroposterior foot X-rays...

The distal attachments of the extensor hallucis longus (EHL) tendons in 47 amputated legs and in eight cadavers were examined. The EHL had two tendons in 34 of the amputated legs and bilaterally in five cadavers. The lateral tendon was inserted to the middle of the dorsal aspect of the base of the distal phalanx of the hallux and the medial tendon to the medial side of the insertion of the lateral tendon. The length and thickness of these two tendons were measured and compared in order to obtain data for using these tendons in tendon repair and hallux varus corrections by autogenous tendon transfer surgery...

In order to assess outcomes and complications, a retrospective study of 38 bunionectomy cases with large displacement distal chevron osteotomy (greater than or equal to 40% lateral translation) for hallux valgus was performed. Follow-up ranged from 12 to 130 months (average, 31 months). Subjective analysis consisting of the American Orthopedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale was performed. Preoperative and postoperative radiographic intermetatarsal (IM) angles and hallux abductus angles were measured and compared...

The instability of the upper and the lower ankle joint represents a serious problem in patients with fibular aplasia. None of the previous techniques demonstrated at least sufficient results. In this report we present a new technique of malleolus externus plasty applied in a 5 1/2-year-old boy with fibular aplasia (type II according to Coventry and Johnson or type Ib according to Achtermann and Kalamchi) with a 6 cm length deficiency of the lower leg and 1 cm of the upper leg. Furthermore, he showed a tibial antecurvation deformity of 20 degrees, a fourth ray foot with adduction deformity of the hindfoot, cutane syndactyly D 2-4, and a hallux varus...

PURPOSE OF THE STUDY: The authors present their philosophy of the surgical treatment of metatarsus primus varus by oblique basal closed osteotomy of 1st metatarsal, evaluate and generalize the results achieved also with regard to the age of patients. MATERIAL: The evaluation covers a group of patients operated on for the mentioned static defect since 1995 with a minimal interval of 12 months after the surgery. From this general group a subgroup has been subsequently singled out of children and adolescents up to the age of 18...

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It is difficult to surgically treat a hallux valgus deformity with significant metatarsus adductus, because the space between the first and second metatarsals is too narrow to correct the metatarsus primus varus with a first metatarsal osteotomy. A 55-year-old woman had severe hallux valgus with significant adduction of the second and third metatarsals. A distal soft tissue procedure and a proximal crescent-shaped osteotomy of the first metatarsal combined with corrective osteotomies of the second and third metatarsals were done...