A biomechanical approach to hallux varus. A case report

Hallux Varus: Correction With the Abductor Hallucis Tendon Transfer and Suture Button Construct Insertion

“…There are many causes of acquired hallux varus including neuromuscular imbalance, trauma, inflammatory arthritis, and unintended consequences of hallux valgus surgical correction and ligament imbalance after fibular sesamoidectomy. 4,5 The most common is because of the attempted correction of a hallux valgus deformity as seen in Figures 1 and 2. This occurs in 2% to 13% of patients undergoing valgus correction.…”

“…The dynamic deformity is on account of an uncoupling of the muscle, tendon, or capsule balance, which leads to instability at the joint. 5 Over the years, different techniques for hallux varus correction ranging from simple soft tissue releases to releases with tendon transfers to osseous intervention have been described. This study modernizes a procedure described by Hawkins in 1971 andClark in 1984.…”

“…[1][2][3][4][5][6][7] Specific iatrogenic causes during valgus correction include excessive tightening of the medial capsule, resecting an excessive amount of the medial eminence, excessive release of the lateral structures, and inadvertent creation of a negative intermetatarsal angle. [4][5][6] The McBride Procedure was the most common procedure that resulted in hallux varus perhaps because of the routine inclusion of the fibula sesamoidectomy. 4,7 Acquired hallux varus can be further classified into static and dynamic deformities.…”