Tendon Transfers and Salvaging Options for Hallux Varus Deformities.

Hallux varus is an infrequently encountered deformity of the first ray characterized by a medial deviation of the hallux on the first metatarsal head at the first metatarsal phalangeal joint. Iatrogenic flexible hallux varus often requires surgical repair to create a functional, pain-free, shoeable foot. Although arthrodesis remains the mainstay of treatment, many soft tissue transfer procedures have been described in the literature as joint-sparing alternatives to fusion. This article explores in detail the tendon transfer procedures that have been described for repair of flexible hallux varus deformity.

Metatarsus Primus Varus Correction.

We present a discussion on the use of proximal first-ray osteotomies in the surgical treatment for hallux valgus as a valid option compared with first-tarsometatarsal arthrodesis. Recent and historical literature tells us that stability of the first ray is a function of the alignment and reestablishment of retrograde stabilizing forces at the first tarsometatarsal joint. This realignment and stabilization may be accomplished with the use of distal soft tissue and proximal osteotomy procedures.