Hallux Varus

Aetiology

  • Usually due to over-correction of Hallux Valgus
    • Excessive lateral release
    • Excessive resection of medial eminence
    • Lateral (fibular) sesamoidectomy – as part of McBride procedure
  • If not iatrogenic, may be:
    • Congenital – related to metatarsus varus, skew foot
    • Part of a neuromuscular condition

Clinical Features

  • Usually isolated
  • 1st MTPJ may be stiff and painful
  • Otherwise, the deformity is well tolerated

Management

  • Reassurance if asymptomatic
  • Shoe wear modifications

Surgical Indications

  • Painful MTPJ
  • Skin problems against shoe wear
  • Tread carefully
    • Correction may further stiffen MTPJ and make patient more symptomatic

Surgical Options

Soft Tissue Correction – if flexible and pain-free

  • Release of Abductor tendon and Split EHL transfer to lateral aspect

PP

  • MTPJ arthrodesis
    • If painful and stiff
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