Failure after Soft-tissue Release with Tendon Transfer for Flexible Iatrogenic Hallux Varus: A Systematic Review

Plovanich, Elizabeth J.; Donnenwerth, Michael P.; Abicht, Bradley P.; Borkosky, Sara L.; Jacobs, Paula; Roukis, Thomas S.

doi:10.1053/j.jfas.2011.11.006

Cited by 23 publications

(13 citation statements)

References 16 publications

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“…The literature reports that the most common operative cause is excessive resection of the first metatarsal head, excessive medial capsulorrhaphy, and overcorrection of the intermetatarsal angle. 22 We attribute the varus in the first case (−8 degrees) to overtightening the medial capsule. In the second case (−13 degrees), the varus appears to have been influenced by progressive varus deformity of the second MTP joint, which the patient elected not to have corrected but which progressed postoperatively.…”

Section: Discussionmentioning

confidence: 96%

Prospective Study of the Treatment of Adult Primary Hallux Valgus With Scarf Osteotomy and Soft Tissue Realignment

et al. 2013

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Section: Discussionmentioning

confidence: 96%

Prospective Study of the Treatment of Adult Primary Hallux Valgus With Scarf Osteotomy and Soft Tissue Realignment

et al. 2013

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“…5,6,23 Others end up being reoperated on many years after the initial surgery, 11 years on average in our series, which is frequent. 1,5,7,19…”

Section: Discussionmentioning

confidence: 99%

“…However, hallux varus may be poorly experienced by both the patient and the surgeon because of the following reasons: transfer metatarsalgia, medial destabilization of lateral MTP joint, conflict between hallux and footwear, secondary arthritis of the MTP1 joint, or unsatisfactory cosmetic appearance. 5,19 Some authors set a degree of varus of 10 or even 15 degrees whereas others agree that there is no parallelism between tolerance and varus. 5,21,23…”

Section: Discussionmentioning

confidence: 99%

Postoperative Hallux Varus Treatment by Reverse Scarf Osteotomy

et al. 2021

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Background: Postoperative hallux varus is often accompanied by an abnormal decrease in the first-second (M1M2) intermetatarsal angle, which we have sought to correct by a reverse scarf-type osteotomy. Methods: A series of 36 hallux varus operated on by reverse scarf osteotomy, including 14 with prior osteotomies, was reviewed with an average follow-up of 56 months. The measurements were clinical: American Orthopaedic Foot & Ankle Society (AOFAS) score, visual analog scale (VAS) pain score, subjective satisfaction index, joint mobility, and radiologic angles: M1M2 and first metatarsophalangeal angle. Results: The M1M2 angle increased on average from 3 to 8 degrees whereas the average M1P1 angle of varus went from −21 to +9 degrees, including 2 patients who had a reoccurring valgus of 20 degrees. The median AOFAS score increased from 47 to 79, the VAS from 6.7 to 2.3, joint mobility lost an average of 9 degrees, and all those operated on were satisfied with the result. All operated bones healed without secondary displacement. Discussion: The reverse scarf osteotomy is capable of correcting the intermetatarsal angle and at the same time correcting the postoperative hallux varus. Functional scores generally improved, including in patients with a reoccurring valgus and those with reduced mobility. Conclusion: The reverse scarf osteotomy can be performed to treat postoperative hallux varus with a mild intermetatarsal angle with reasonable clinical and radiologic results. Level of Evidence: Level III, retrospective cohort study.

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“…15 Arthrodesis remains the mainstay of treatment because it is commonly thought that soft tissue procedures will ultimately fail. However, a systematic review of the literature by Plonavich and colleagues 16 recently found that soft tissue procedures seem to be an acceptable option with predictable results for the first-line treatment of iatrogenic flexible hallux varus. Arthrodesis should be reserved for cases of recalcitrant hallux varus with damage to the MPJ.…”

Section: Discussionmentioning

confidence: 99%