Prenatal diagnosis of congenital hallux varus deformity associated with pericentric inversion of chromosome 9.

Congenital hallux varus is a rare deformity of the great toe characterized by adduction of the hallux and medial displacement of the first metatarsophalangeal joint. Prenatal diagnosis of congenital hallux varus is presented herein. A 32-year-old woman was referred to our unit due to significant deviation of the fetal right great toe at 22(+2) weeks of pregnancy. Ultrasound examination revealed a thick and short great toe, which was significantly angulated medially on the right side. Amniocentesis was performed and the result was reported as inv(9) (p11;q12). After delivery, the clinical examination confirmed the prenatal diagnosis. To our knowledge, this is the first reported prenatal diagnosis of an isolated congenital hallux varus. Congenital hallux varus can be diagnosed easily in the prenatal period by 2-D and 4-D ultrasonography. Prenatal karyotyping should be taken into consideration, especially in the presence of associated anomalies, such as polydactyly and clubfoot.

Patomecánica del retropié varo. Caso clínico / Varus rarefoot pathomechanics. Clinical case

En este trabajo se presenta la resolución de un caso clínico, paciente que acudió a nuestra consulta por presentar dolor a nivel de la 23 cabeza metatarsal del pie izquierdo. Diagnosticarnos al paciente de retropié varo parcialmente compensado y se elaboró un tratamiento ortopodológico para compensar dicha patología, así como solucionar el motivo de consulta. Esto nos llevó a realizar una revisión bibliográfica sobre dicha patología, etiología, diagnostico, repercusiones clínicas y tratamiento ortopodológico (AU)

This article presents the resolution of a clinical case, about a patient who came to our Centre because of pain at 2ª head metatarsal on the left foot. Our diagnose was rearfoot varus partially compensated and was elaborated an orthotic therapy to compensate the above mentioned pathology, as well as to solve the problem. This led us to realize a bibliographical review of that pathology, etiology, diagnosis, clinical repercussions and orthotic therapy (AU)

[Hallux varus congenitus]. / Der Hallux varus congenitus.

INTRODUCTION: The congenital hallux varus is a rare hereditary deformity of the big toe, which often is combined either with polydactylia or with systemic deformities of the skeleton. The congenital hallux varus can be easily diagnosed clinically. The X-ray shows the ossified bony elements and provides information about the shape and number of the digits as well as their axial deviation. An operative treatment is required. So far a standardized surgical technique has not been accepted for all types of hallux varus. METHODS: The correction of the bony structures and soft tissues is planned by means of preoperative scetches. The amount of correction depends on the degree of the deformity. As consequence of the reorientation of the first ray a soft tissue flap has to be planned and prepared for wound closure which otherwise would need larger grafts. RESULTS: Based on this series the clinical and radiological appearance of the congenital hallux varus are discussed. The operative treatment is explained step by step illustrated by photographs as well as planing scetches. Our procedures are compared to other operative methods reported in the literature. CONCLUSIONS: There are no diagnostic problems with the hallux varus deformity. For therapy surgery is mandatory and recommended between 9 and 24 months of age. For microsurgical preparation and correction of the deformity planning of all surgical steps and alternatives is advocated, this allows for good functional and cosmetic results.