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Saiouf Y, Al Aji N, Ali Nizam N, Ibrahim A, Laila A. Bilateral congenital hallux varus with metatarsus adductus in a 6-year-old girl: A case report. World J Clin Cases 2025; 13:105327. [DOI: 10.12998/wjcc.v13.i20.105327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2025] [Revised: 03/10/2025] [Accepted: 03/20/2025] [Indexed: 04/09/2025] Open
Abstract
BACKGROUND Congenital hallux varus (CHV) is a rare form of hallux varus deformity, characterized by medial deviation of the first toe at the metatarsophalangeal joint. It may be primary or secondary and presents clinically with pain and asymmetry with footwear.
CASE SUMMARY We documented a case of a 6-year-old girl with bilateral CHV, accompanied by adduction of the toes in the left foot. Clinical diagnosis was made by physical examination and X-ray imaging based on Bleck’s classification. Conservative treatment did not show any noticeable improvement, so the child underwent corrective surgeries on both feet.
CONCLUSION The patient’s family history is positive, which requires us to take into account the importance of checking for a family history with any complaint of CHV, and both feet must be evaluated to confirm whether the deformity is unilateral or bilateral.
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Affiliation(s)
- Yaman Saiouf
- Faculty of Medicine, Damascus University, Damascus E5N 2B9, Dimashq, Syria
| | - Nuha Al Aji
- Faculty of Medicine, Damascus University, Damascus E5N 2B9, Dimashq, Syria
| | - Nabeel Ali Nizam
- Faculty of Medicine, Damascus University, Damascus E5N 2B9, Dimashq, Syria
| | - Alia Ibrahim
- Faculty of Medicine, Damascus University, Damascus E5N 2B9, Dimashq, Syria
| | - Abdulrahman Laila
- Department of Orthopedic Surgery, Al Asaad University Hospital, Al Mowasat University Hospital, University Pediatric Hospital, Damascus, Damascus 31002, Dimashq, Syria
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Ortiz-Romero M, Fernandez-Garzon A, Pabon-Carrasco M, Castro-Mendez A, Gordillo-Fernandez LM. Iatrogenic Hallux Varus in a Patient with Rheumatoid Arthritis. Healthcare (Basel) 2025; 13:217. [PMID: 39942406 PMCID: PMC11817015 DOI: 10.3390/healthcare13030217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2024] [Revised: 01/12/2025] [Accepted: 01/18/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: Iatrogenic hallux varus is a rare complication often arising after hallux valgus surgery, characterized by medial deviation of the hallux. This report presents the case of a 58-year-old female with iatrogenic hallux varus complicated by rheumatoid arthritis (RA). The objective is to highlight the challenges and outcomes of surgical treatment in RA patients with complex foot deformities. Methods: The patient presented with severe medial deviation of the hallux and claw positioning of the lesser toes, resulting in pain and functional limitations. Radiological analysis indicated overcorrection of the first intermetatarsal angle and deformity of the lesser toes. Surgical management included arthrodesis of the first metatarsophalangeal (MTP) joint using K-wires and resection arthroplasty of the lesser metatarsals. Results: Postoperative outcomes revealed correct alignment, pain reduction, and restoration of functional capabilities. However, a non-union was observed in the first MTP arthrodesis after 24 months, which remained asymptomatic. Conclusions: This case underscores the importance of careful surgical planning in RA patients to balance joint preservation and deformity correction. Arthrodesis proved effective for stability and pain relief in RA-associated deformities, although long-term follow-up remains critical to address complications. Tailored interventions are necessary to improve the quality of life in RA patients with complex foot deformities.
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Affiliation(s)
- Mercedes Ortiz-Romero
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.O.-R.); (A.C.-M.); (L.M.G.-F.)
| | | | - Manuel Pabon-Carrasco
- “CTS-1054: Interventions and Health Care, Red Cross (ICSCRE)”, Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, 41009 Seville, Spain;
| | - Aurora Castro-Mendez
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.O.-R.); (A.C.-M.); (L.M.G.-F.)
| | - Luis M. Gordillo-Fernandez
- Department of Podiatry, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain; (M.O.-R.); (A.C.-M.); (L.M.G.-F.)
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Manni A, Zouirech Y, Rouijel B, Hosni S, El Madhi T. Congenital Hallux Varus in Children: A Case of Bilateral Presentation. Cureus 2025; 17:e77844. [PMID: 39991321 PMCID: PMC11845259 DOI: 10.7759/cureus.77844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2025] [Indexed: 02/25/2025] Open
Abstract
Congenital hallux varus (CHV) is an uncommon deformity of the forefoot, defined by the medial deviation of the great toe at the metatarsophalangeal joint, often accompanied by a wide gap between the first and second toes. This condition is associated with footwear difficulties, pain impacting quality of life, and aesthetic concerns. CHV may occur in isolation or alongside other congenital foot abnormalities, such as polysyndactyly or a longitudinal epiphyseal bracket (LEB). We present the case of a 19-month-old boy with bilateral CHV featuring a shortened first metatarsal and significant functional impairment. Surgical correction resulted in a favorable outcome, emphasizing the importance of early intervention.
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Affiliation(s)
- Abir Manni
- Department of Pediatric Orthopedic Surgery "B" Children's Hospital of Rabat, Ibn Sina University Hospital Center, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Rabat, MAR
| | - Yacine Zouirech
- Department of Pediatric Orthopedic Surgery "B" Children's Hospital of Rabat, Ibn Sina University Hospital Center, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Rabat, MAR
| | - Badr Rouijel
- Department of Pediatric Orthopedic Surgery "B" Children's Hospital of Rabat, Ibn Sina University Hospital Center, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Rabat, MAR
| | - Sarah Hosni
- Department of Pediatric Orthopedic Surgery "B" Children's Hospital of Rabat, Ibn Sina University Hospital Center, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Rabat, MAR
| | - Tarik El Madhi
- Department of Pediatric Orthopedic Surgery "B" Children's Hospital of Rabat, Ibn Sina University Hospital Center, Mohammed V University, Faculty of Medicine and Pharmacy of Rabat, Rabat, MAR
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Sankova MV, Beeraka NM, Oganesyan MV, Rizaeva NA, Sankov AV, Shelestova OS, Bulygin KV, Vikram PR H, Barinov A, Khalimova A, Padmanabha Reddy Y, Basappa B, Nikolenko VN. Recent developments in Achilles tendon risk-analyzing rupture factors for enhanced injury prevention and clinical guidance: Current implications of regenerative medicine. J Orthop Translat 2024; 49:289-307. [PMID: 39559294 PMCID: PMC11570240 DOI: 10.1016/j.jot.2024.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 08/16/2024] [Accepted: 08/27/2024] [Indexed: 11/20/2024] Open
Abstract
Background In recent years, many countries have actively implemented programs and strategies to promote physical education and sports. Despite these efforts, the increase in physical activity has been accompanied by a significant rise in muscle and tendon-ligament injuries, with Achilles tendon rupture being the most prevalent, accounting for 47 % of such injuries. This review aims to summarize all significant factors determining the predisposition of the Achilles tendon to rupture, to develop effective personalized prevention measures. Objective To identify and evaluate the risk factors contributing to Achilles tendon rupture and to develop strategies for personalized prevention. Methods This review utilized data from several databases, including Elsevier, Global Health, PubMed-NCBI, Embase, Medline, Scopus, ResearchGate, RSCI, Cochrane Library, Google Scholar, eLibrary.ru, and CyberLeninka. Both non-modifiable and modifiable risk factors for Achilles tendon injuries and ruptures were analyzed. Results The analysis identified several non-modifiable risk factors, such as genetic predisposition, anatomical and functional features of the Achilles tendon, sex, and age. These factors should be considered when selecting sports activities and designing training programs. Modifiable risk factors included imbalanced nutrition, improper exercise regimens, and inadequate monitoring of Achilles tendon conditions in athletes. Early treatment of musculoskeletal injuries, Achilles tendon diseases, foot deformities, and metabolic disorders is crucial. Long-term drug use and its risk assessment were also highlighted as important considerations. Furthermore, recent clinical advancements in both conventional and surgical methods to treat Achilles tendon injuries were described. The efficacy of these therapies in enhancing functional outcomes in individuals with Achilles injuries was compared. Advancements in cell-based and scaffold-based therapies aimed at enhancing cell regeneration and repairing Achilles injuries were also discussed. Discussion The combination of several established factors significantly increases the risk of Achilles tendon rupture. Addressing these factors through personalized prevention strategies can effectively reduce the incidence of these injuries. Proper nutrition, regular monitoring, timely treatment, and the correction of metabolic disorders are essential components of a comprehensive prevention plan. Conclusion Early identification of Achilles tendon risk factors allows for the timely development of effective personalized prevention strategies. These measures can contribute significantly to public health preservation by reducing the incidence of Achilles tendon ruptures associated with physical activity and sports. Continued research and clinical advancements in treatment methods will further enhance the ability to prevent and manage Achilles tendon injuries. The translational potential of this article This study identifies key modifiable and non-modifiable risk factors for Achilles tendon injuries, paving the way for personalized prevention strategies. Emphasizing nutrition, exercise, and early treatment of musculoskeletal issues, along with advancements in cell-based therapies, offers promising avenues for improving recovery and outcomes. These findings can guide clinical practices in prevention and rehabilitation, ultimately reducing Achilles injuries and enhancing public health.
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Affiliation(s)
- Maria V. Sankova
- Department of Human Anatomy and Histology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Narasimha M. Beeraka
- Department of Human Anatomy and Histology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Anantapuramu, Chiyyedu, Andhra Pradesh, 515721, India
- Herman B. Wells Center for Pediatric Research, Department of Pediatrics, Indiana University School of Medicine, 1044 W. Walnut Street, R4-168, Indianapolis, IN, 46202, USA
| | - Marine V. Oganesyan
- Department of Human Anatomy and Histology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow, Russia
| | - Negoriya A. Rizaeva
- Department of Human Anatomy and Histology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow, Russia
| | - Aleksey V. Sankov
- Department of Human Anatomy and Histology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Olga S. Shelestova
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow, Russia
| | - Kirill V. Bulygin
- Department of Human Anatomy and Histology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow, Russia
| | - Hemanth Vikram PR
- Department of Pharmaceutical Chemistry, JSS College of Pharmacy, JSS Academy of Higher Education & Research (JSS AHER), Mysuru, Karnataka, India
| | - A.N. Barinov
- Head of Neurology and Psychotherapy Chair of Medical Academy MEDSI Group, Moscow, Russia
| | - A.K. Khalimova
- International Medical Company “Prime Medical Group”, Almaty, Kazakhstan Asia Halimova Prime Medical Group Medical Center, Republic of Kazakhstan
| | - Y. Padmanabha Reddy
- Raghavendra Institute of Pharmaceutical Education and Research (RIPER), Anantapuramu, Chiyyedu, Andhra Pradesh, 515721, India
| | - Basappa Basappa
- Laboratory of Chemical Biology, Department of Studies in Organic Chemistry, University of Mysore, Mysore, Karnataka, 570006, India
| | - Vladimir N. Nikolenko
- Department of Human Anatomy and Histology, I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Normal and Topographic Anatomy, Lomonosov Moscow State University, Moscow, Russia
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Belfiore S, Vaggi S, Vitali F, Zanirato A, Quarto E, Formica M. Rigid iatrogenic hallux varus: a decades' worth experience with arthrodesis of the metatarsophalangeal joint. INTERNATIONAL ORTHOPAEDICS 2024; 48:2923-2929. [PMID: 39297966 PMCID: PMC11490511 DOI: 10.1007/s00264-024-06321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 09/09/2024] [Indexed: 09/21/2024]
Abstract
PURPOSE Arthrodesis of the first ray metatarsophalangeal joint (MPJ) is the gold standard in iatrogenic hallux varus (IHV) in the presence of stiffness and osteoarthritis. The purpose of this study is to collect clinical and radiographic results and complications of MPJ arthrodesis in rigid iatrogenic HV. METHODS A retrospective evaluation of rigid iatrogenic HV undergoing arthrodesis with a minimum follow-up (FU) of two years was performed. The clinical parameters assessed were visual analog scale (VAS), the AOFAS Hallux Metatarsophalangeal-Interphalangeal Scale score and the satisfaction scale. The radiological parameters evaluated the first to second metatarsal angle (IMA) and the angle of hallux valgus (HVA). Complications were also analysed. RESULT A total of 18 patients (19 procedures) with a mean FU of 5.5 ± 2.5 years were included. The mean VAS improved from 7.3 ± 1.6 to 1.3 ± 1.2 (p < 0.05) at the last FU. Similarly, the AOFAS Hallux Metatarsophalangeal-Interphalangeal scale score significantly improved to 82 ± 9.2 (p < 0.05). Radiological evaluation demonstrated a 1-2 IMA improvement from 4.4 ± 2.2° preoperatively to 8.9 ± 2.4° at 3 months post-operatively. Similarly, there was a significant (p < 0.05) improvement of the HVA from - 22.7 ± 4.1° to 13.1 ± 4.1° at three months post-operative (p < 0.05). No signification loss of correction was noted at the last follow-up (p > 0.05). In one case, a delayed fusion at the arthrodesis site required surgical revision to promote fusion. No patient experienced pain with stress from the first MTP joint arthrodesis site or identified the arthrodesis site as a source of pain. No patient required implant removal. Re-operation and revision rates were 5.3%. The overall complications rate was 15.8%. CONCLUSIONS MPJ fusion effectively corrects Iatrogenic Hallux Varus in cases of rigid and fixed deformities in the medium- to long-term follow-up, with lasting improvements in AOFAS and VAS scores. The procedure is characterised by a non-negligible risk of complications, reoperations and revisions. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- S Belfiore
- Ospedale Evangelico Internazionale - Salita Superiore, San Rocchino 31/A, 16122, Genova, GE, Italy
| | - S Vaggi
- Ospedale Evangelico Internazionale - Salita Superiore, San Rocchino 31/A, 16122, Genova, GE, Italy
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli studi di Genova - DISC, Viale Benedetto XV 6, 16132, Genova, GE, Italy
| | - F Vitali
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli studi di Genova - DISC, Viale Benedetto XV 6, 16132, Genova, GE, Italy
- IRCCS Ospedale Policlinico San Martino - Clinica Ortopedica, Largo Rosanna Benzi, 10 16132 GENOVA, 16132, Genova, GE, Italy
| | - A Zanirato
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli studi di Genova - DISC, Viale Benedetto XV 6, 16132, Genova, GE, Italy.
- IRCCS Ospedale Policlinico San Martino - Clinica Ortopedica, Largo Rosanna Benzi, 10 16132 GENOVA, 16132, Genova, GE, Italy.
| | - E Quarto
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli studi di Genova - DISC, Viale Benedetto XV 6, 16132, Genova, GE, Italy
- IRCCS Ospedale Policlinico San Martino - Clinica Ortopedica, Largo Rosanna Benzi, 10 16132 GENOVA, 16132, Genova, GE, Italy
| | - M Formica
- Dipartimento di Scienze Chirurgiche e Diagnostiche Integrate, Università degli studi di Genova - DISC, Viale Benedetto XV 6, 16132, Genova, GE, Italy
- IRCCS Ospedale Policlinico San Martino - Clinica Ortopedica, Largo Rosanna Benzi, 10 16132 GENOVA, 16132, Genova, GE, Italy
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Kondo N, Igarashi T, Inukai T, Kawashima H. Case Report: Postsurgical hallux varus in which metatarsophalangeal joint arthrodesis was useful. F1000Res 2024; 12:344. [PMID: 40206187 PMCID: PMC11979576 DOI: 10.12688/f1000research.131495.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 04/11/2025] Open
Abstract
A 74-year-old Japanese woman who underwent Mann's procedure with fibular sesamoidectomy for left hallux valgus 21 years ago complained of left hallucis pain. She was diagnosed with iatrogenic hallux varus and hammer toe deformities. Metatarsophalangeal joint arthrodesis and shortening oblique osteotomy were performed. After surgery, the hallux valgus angle improved from -28° to 0°, and the intermetatarsal angle between the first and the second metatarsus improved from 0° to 6°. The Japanese Society for Surgery of the Foot RA foot and ankle scale improved from 73 to 81 points. She could walk without pain and sustained no deformity at 4 years after the surgery.
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Affiliation(s)
- Naoki Kondo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, 951-8510, Japan
| | - Tetsuya Igarashi
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, 951-8510, Japan
| | - Tomoya Inukai
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, 951-8510, Japan
| | - Hiroyuki Kawashima
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, 951-8510, Japan
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Wang C, Wang Z, Zhao H, Zhang M. Radiologic and Clinical Outcomes of the Dovetailed Notch Scarf Osteotomy for Correcting the First Metatarsal Pronation in Moderate to Severe Hallux Valgus Deformity: A Comparative Study. Foot Ankle Int 2024; 45:728-736. [PMID: 38634422 DOI: 10.1177/10711007241238226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND The traditional scarf osteotomy (TSO) has limited ability to correct the first metatarsal pronation. A novel modification that we refer to as a "dovetailed notch scarf osteotomy" (DNSO) has been developed to enhance the ability to correct coronal plane pronation. The study aimed to observe and compare TSO to DNSO in the treatment of moderate to severe hallux valgus deformity. METHODS This retrospective study included 78 feet that had a TSO and 105 feet that had a DNSO. Minimum follow-up was 24 months. Weightbearing computed tomography (WBCT) and weightbearing anterior-posterior (AP) radiographs were taken preoperatively and at the last follow-up. We measured the intermetatarsal angle (IMA), hallux valgus angle, distal metatarsal articular surface angle on AP radiographs and first metatarsal coronal pronation angle (α angle), tibial sesamoid coronal grading, and first metatarsal length on WBCT. Clinical assessment was done using visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale, Foot and Ankle Ability Measure (FAAM), and the 36-Item Short Form Health Survey (SF-36). The occurrence of postoperative complications was also documented. RESULTS The DNSO group exhibited a significantly higher correction amount of α angle and IMA (14.3 ± 9.9 and 10.3 ± 4.6 degrees) than the TSO group (8.6 ± 5.9 and 5.4 ± 5.9 degrees) during the final follow-up assessment (P < .05).The DNSO group (10.1 [8.0-12.0] degrees and 4.8 [3.9-5.6] degrees) demonstrated significantly smaller α angle and IMA compared with the TSO group (4.8 [3.9-5.6] degrees and 9.5 [7.5-11.5] degrees) at 24 months postsurgery (P < .05). The postoperative FAAM activities of daily living and SF-36 physical functioning scores were significantly higher in the DNSO group (97.2 ± 3.3 and 95.7 ± 4.4 points) compared with the TSO group (92.3 ± 3.3 and 87.7 ± 8.7 points) (P < .05). Additionally, hallux varus occurred in 1 case in the DNSO group, whereas 4 cases were observed in the TSO group. CONCLUSION Two osteotomy methods can effectively correct moderate to severe hallux valgus deformity. Compared with the TSO, the DNSO has stronger correction ability. The most crucial aspect lies in its controllability when correcting first metatarsal pronation and addressing IMA. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- Chao Wang
- Center of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhi Wang
- Center of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hongmou Zhao
- Foot and Ankle Surgery Department, Honghui Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mingzhu Zhang
- Center of Foot and Ankle Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Gottlich C, Murphy A, Jain N, Grimes J. Use of botulinum toxin as a non-surgical treatment option for idiopathic hallux varus: a case report. J Surg Case Rep 2023; 2023:rjad423. [PMID: 37528913 PMCID: PMC10390077 DOI: 10.1093/jscr/rjad423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 07/04/2023] [Indexed: 08/03/2023] Open
Abstract
Hallux varus presents with midline deviation of the hallux at the first metatarsophalangeal joint. If left untreated, it may lead to pain and difficulty with normal daily activities. Here, we present a case of spontaneous hallux varus in an 84-year-old female treated non-operatively with injection of botulinum toxin in the Abductor Hallucis Brevis. Ultrasound guidance with electromyography was used to assist in all injections. Near total symptomatic relief and resumption of daily activities was obtained for up to 12 weeks at a time. Radiographic correction seen was improvement from 14° to 7° on weight bearing radiographs. After five rounds of treatment, no adverse reactions had been observed.
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Affiliation(s)
- Caleb Gottlich
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center Lubbock, TX, USA
| | - Alexandria Murphy
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center Lubbock, TX, USA
| | - Neil Jain
- Correspondence address. Department of Orthopedic Surgery, Texas Tech University Health Science Center, 3601 4th St, Lubbock, TX 79430, USA. Tel: (806) 743-4115; Fax: (806)743-1305; E-mail:
| | - Jerry Grimes
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center Lubbock, TX, USA
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Samelis PV, Kolovos P, Nikolaou S, Samelis VP, Markeas NG. Primary Congenital Hallux Varus: A Step-Cut Surgical Approach. Cureus 2022; 14:e28075. [PMID: 36127972 PMCID: PMC9477511 DOI: 10.7759/cureus.28075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/05/2022] Open
Abstract
Hallux varus is a rare deformity of the forefoot, which is characterized by medial deviation of the proximal phalanx of the great toe at the metatarsophalangeal joint. It is usually acquired, secondary to failed hallux valgus surgery, trauma, neurologic or rheumatologic disease. Rarely, this deformity may be congenital, either isolated, or in the context of various underlying congenital malformations of the foot, such as poly-syndactyly or longitudinal epiphyseal bracket, or part of generalized skeletal malformations. We present a case of bilateral congenital hallux varus with concomitant short first metatarsal in a three-year-old girl. A step-cut soft-tissue surgical procedure to achieve proper alignment of the medial ray of the foot is described.
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