McG 37: Hallux Varus Flashcards
what happens if hallux varus is not corrected
osteoarthritis develops
causes for Hallux varus
- overaggressive splint age of the hallux post-op
- overaggressive lateral release w/ or w/o lateral sesamoidectomy
- disruption of the muscle tendon balance to favor the pull of the ABH
factors contributing to hallux varus
- long or short 1st MT segment
- rounded 1st MT head
- negative IMA
- ligamentous laxity
- inadvertant staking of the sagittal groove of the 1st MT head
hallux varus occurrence
2-17%
hallux varus can be divided into what 2 categories
static and dynamic
causes of static hallux varus
osteotomies: Silver, MTPJ arthroplasty
causes of dynamic hallux varus
-muscle tendon imbalance favoring the ABH (see long explanation in notes)
causes of overcorrection in bunion sx
- excessive medial exostecotmy
- overaggressive medial capsulorrhaphy
- overaggressive plantar lateral release
- overaggressive osseous correction
- overzealous postoperative bandaging
- combo of the above
reversal for a medial luxated joint
medial capsulotomy and digital splinting
reversal for a subluxed hallux
complete ST release and a MT osteotomy
what do you do if the deformity is reducible, but the normal morphology of the MT head has been lost?
reconstruction of the articular groove for the hallux and tibial sesamoid
if motion is restricted and/or crepitant when the hallux is seated in neutral
fusion
