Posted on March 16, 2008 in Latest News
Hallux varus is a foot disorder in which the big toe is placed away from the next toe so that the two toes seem to be split or spread apart. The most common reason for hallux varus is a failed bunion surgery or the complications following it. Flexible hallux varus is a common condition in newborn babies and usually corrects to valgus in early childhood when the child begins to walk.
Hallux varus has been reported as a simple transverse plane deformity, and in such cases, is referred to as hallux adductus. The hallux varus deformity,however, is triplanar, which means involving supination of the first metatarsophalangeal joint, hyperextension of the first metatarsophalangeal joint, and hyperflexion of the hallux interphalangeal joint (Fig. 22-1). The hallux is deviated or subluxed medially with a nonpurchasing digit in varus rotation with a possible negative angle between the first and second metatarsals.
Diagnosis
Trauma should also be considered as a possible cause of this condition. Injury to the great toe, which disrupts the mechanical balance of the tendons, can lead to this abnormal deviation of the toe. A careful history and clinical examination will often lead the physician to the correct cause.
Treatment
Like any other disorder, the treatment of hallux varus too depends on the extent of severity of the disease. Surgery becomes a necessity when the great toe deviates noticeably and becomes stiff. When addressing a varus correction, the soft tissues around the first metatarsophalangeal joint should first be evaluated to determine their influence in creating and maintaining the deformity. The medial capsule should be opened in such a manner as to allow for lengthening and closure.
When an implant arthroplasty is being considered, joint stability must be thoroughly evaluated. Implants, by design, are meant only to act as joint spacers and therefore they will not stand up to abnormal biomechanical forces over time.
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