Fact or Fiction? Iatrogenic Hallux Abducto Valgus Secondary to Tibial Sesamoidectomy

Tibial sesamoidectomy: Case series and review of literature

“…Canales, et al's cadaveric study demonstrated that isolated tibial sesamoidectomy does not likely lead to medial instability or imbalance of the first MTPJ. In the same study, their five patients demonstrated a statistically significant decrease in pain after tibial sesamoidectomy and no postoperative HAV deformity [7]. Both articles emphasized the importance of preserving surrounding soft tissue structures of the first MTPJ to avoid structural complications such as HAV.…”

“…Two studies that focused on isolated tibial sesamoidectomy for tibial sesamoiditis and its postoperative effect on alignment and functional complications summarized that hallux alignment and first MTPJ function can be maintained with meticulous dissection with soft tissue repair [6,7]. Lee, et al, found that 30% of their patients had difficulty or inability to stand on their tiptoes but did not impact their sports as athletes or activities of daily living.…”

“…Lee, et al, showed that a tibial sesamoidectomy resulted in a weak hallux at push-off or transfer metatarsalgia [6]. Canales, et al, demonstrated that 1 in 13 of their patients presented with a hallux valgus postoperatively [7]. Saxena and Krisdakumtorn reported a patient who developed loss of hallux flexion [9].…”

Tibial Sesamoid Graft as a Treatment for Chronic Unstable Proximal Interphalangeal Joint Fracture Dislocation, a New Surgical Technique

“…As far as we know, sesamoidectomy has never been used as an osteochondral graft, but many authors described sesamoidectomy as a treatment of choice to treat sesamoid disorders such as fracture or sesamoiditis [27][28][29][30][31][32]. Several studies showed that isolated tibial sesamoidectomy with soft tissue repair is efficacious and safe even for the patient populations with the highest physical demands [28,[33][34][35][36][37][38][39][40][41]. The donor site was easy to access in our technique and graft harvesting was simple in contrast to the osteochondral graft in HHA which, as mentioned above, is complex, difficult and technically challenging with steep learning curve [20].…”

Radiographic Results and Return to Activity After Sesamoidectomy for Fracture

“…Downey and Lawrence 5 suggested that in cases of medial sesamoidectomy, a resultant hallux valgus may just be a case of anecdotal evidence becoming dogma. In the only study to compare preoperative and postoperative first ray alignment, Canales et al 3 reported that no statistically significant difference was detected comparing HVA and IMA in patients undergoing medial sesamoidectomy. In the 5 patients studied, there was a slight increase in HVA (10.6 to 12 degrees) and IMA (7.8 to 8.8 degrees), although this was not detected to be statistically significant.…”