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

Abstract

Hallux varus is an uncommon deformity that may present with cosmetic dissatisfaction, difficulty with shoe wear, function impairment, and pain. It is classified into 2 forms: congenital and acquired forms. This technique paper will mainly focus on the acquired variant of hallux valgus. There are many causes of acquired hallux varus, but the most common is because of attempted correction of a hallux valgus deformity. 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 describing the use of the abductor hallucis tendon for the correction of the varus deformity. As the abductor hallucis muscle is a deforming force in hallux varus, release of the tendon is necessary to correct the deformity. Instead of just letting the tendon retract after being released, this procedure transfers the tendon to correct the dynamic imbalance at the first metatarsophalangeal joint and uses supplementary stabilization. It obviates the sacrifice of the extensor hallucis longus or extensor hallucis brevis tendons and spares the interphalangeal joint of the hallux.