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