Clin Orthop Surg.  2014 Jun;6(2):216-222. 10.4055/cios.2014.6.2.216.

Surgical Treatment of Congenital Hallux Varus

• Shim JS
• Lim TK
• Koh KH
• Lee DK

• KMID: 1784670
• DOI: http://doi.org/10.4055/cios.2014.6.2.216

Abstract

BACKGROUND
The purpose of this study was to report outcomes of congenital hallux varus deformity after surgical treatment.
METHODS
We evaluated ten feet of eight patients with a congenital hallux varus deformity, including four feet combined with a longitudinal epiphyseal bracket (LEB). There were seven male patients and one female patient with a mean age of 33 months (range, 7 to 103 months) at the time of surgery. Two patients were bilaterally involved. The mean duration of follow-up was 5.9 years (range, 2.3 to 13.8 years). Clinical outcomes were assessed according to the criteria of Phelps and Grogan. Surgical procedures included the Farmer procedure, the McElvenny procedure or an osteotomy at the first metatarsal or proximal phalanx.
RESULTS
The clinical results were excellent in two feet, good in six and poor in two feet. The LEB was associated with hallux varus in four feet and were treated by osteotomy alone or in conjunction with soft tissue procedure.
CONCLUSIONS
Congenital hallux varus was successfully corrected by surgery with overall favorable outcome. Preoperatively, a LEB should be considered as a possible cause of the deformity in order to prevent recurrent or residual varus after surgery.

Keyword

Congenital hallux varus; Longitudinal epiphyseal bracket; Surgical treatment

MeSH Terms

Child
Child, Preschool
Female
Foot Deformities, Congenital/radiography/*surgery
Hallux Varus/radiography/*surgery
Humans
Infant
Male
Osteotomy

Figure

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  Fig. 1 Patient 7. (A) Preoperative photograph showing bilateral hallux varus with widening of the first web space. Preoperative scars due to removal of accessory toes are also noted. (B) Preoperative radiograph of the right foot at 58 months of age showing a short thickened first metatarsal, which might result from closure of the physis between the bracket and diaphysis. Radiographs at the immediate postoperative follow-up (C) and at the final follow-up (D).

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  Fig. 2 Patient 2. (A) Preoperative photograph showing marked medial deviation of the broad great toe and widening of the first web space. (B) Preoperative radiograph showing varus angulation of the first metatarsophalangeal joint and accessory bone of the great toe. (C) Follow-up photograph. (D) Sufficient correction with cosmetically satisfactory appearance of the foot was observed at four years after the Farmer technique and medial open wedge osteotomy at the proximal phalanx. The final result was graded as excellent at 10 years after surgery.

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