Acquired hallux varus.

Cleveland Clinic, Department of Orthopaedic Surgery, Ohio, USA.
Foot & Ankle International (Impact Factor: 1.47). 10/1997; 18(9):586-92. DOI: 10.1177/107110079701800911
Source: PubMed

ABSTRACT Acquired hallux varus most commonly occurs after hallux valgus surgery. Sagittal plane, coronal plane, and varus deformities are present at the metatarsophalangeal joint. Evaluation of both the metatarsophalangeal and interphalangeal joints for mobility is necessary in surgical decision making. Not all patients require surgery. The anatomy, incidence, pathogenesis, evaluation, classification, and treatment of acquired hallux varus are discussed in this review.

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    ABSTRACT: Though uncommon, iatrogenic hallux varus is most often the result of overresection of the medial eminence, overtranslation of an osteotomy, overrelease of the lateral soft tissues, or overtightening of the medial tissues. It is not always symptomatic, as the degree of deformity can be well tolerated. For soft-tissue reconstructions, releases have little role to play unless minor deformity is detected early on and the longevity of tendon transfer and tenodesis remains unknown. For bony reconstruction, arthrodesis is the recommended salvage technique.
    Foot and Ankle Clinics. 01/2014;
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    ABSTRACT: Iatrogenic hallux varus is a relatively rare complication of corrective hallux valgus surgery that has multiple pathologic facets. It requires a comprehensive assessment that focuses on joint flexibility, joint integrity, soft tissue balance, and bony deformity. A step-wise treatment approach is used to address all elements of the deformity. The literature on hallux varus treatments consists mainly of retrospective case series, with several proposed procedures addressing various degrees of deformity. Comparison of these procedures is a challenging endeavor and each case should be considered on an individual basis.
    Foot and Ankle Clinics. 01/2014;
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    ABSTRACT: The Cochrane review of hallux valgus surgery has disputed the scientific validity of hallux valgus research. Scoring systems and surrogate measures such as x-ray angles are commonly reported at just one year post operatively but these are of dubious relevance to the patient. In this study we extended the follow up to a minimum of 8 years and sought to address patient specific concerns with hallux valgus surgery. The long term follow up also allowed a comprehensive review of the complications associated with the combined rotation scarf and Akin osteotomies. Between 1996 and 1999, 101 patients underwent rotation scarf and Akin osteotomies for the treatment of hallux valgus. All patients were contacted and asked to participate in this study. 50 female participants were available allowing review of 73 procedures. The average follow up was over 9 years and the average age at the time of surgery was 57. The participants were physically examined and interviewed. Post-operatively, in 86% of the participants there were no footwear restrictions. Stiffness of the first metatarsophalangeal joint was reported in 8% (6 feet); 10% were unhappy with the cosmetic appearance of their feet, 3 feet had hallux varus, and 2 feet had recurrent hallux valgus. There were no foot-related activity restrictions in 92% of the group. Metatarsalgia occurred in 4% (3 feet). 96% were better than before surgery and 88% were completely satisfied with their post-operative result. Hallux varus was the greatest single cause of dissatisfaction. The most common adverse event in the study was internal fixation irritation. Hallux valgus surgery is not without risk and these findings could be useful in the informed consent process. When combined the rotation scarf and Akin osteotomies are an effective treatment for hallux valgus that achieves good long-term correction with a low incidence of recurrence, footwear restriction or metatarsalgia. The nature of the osteotomies allows early return to normal shoes and activity without the need for postoperative immobilisation in a plaster cast.
    Journal of Foot and Ankle Research 02/2010; 3:2. · 1.47 Impact Factor