Hallux Varus and Rigidus

Abstract

The treatment options for isolated hallux varus and for hallux rigidus have been well described in the literature; however, the combination of these 2 pathologies in the same patient presents a unique challenge for the foot and ankle specialist. Traditional treatment options include nonoperative shoe modifications and orthoses versus first metatarsophalangeal joint arthrodesis. We describe a novel technique for motion preservation in these patients using a combination of interposition arthroplasty with dermal matrix and semitendinosus allograft to reconstruct the lateral ligaments of the first metatarsophalangeal joint. Level of Evidence: Diagnostic Level 5. See Instructions for Authors for a complete description of levels of evidence.FIGURE 3. After the joint is exposed, the convex reamer in positioned for preparation of the metatarsal head. FIGURE 4. The proximal phalanx is next prepared with an eccentric dorsal-based reaming that leaves the plantar attachments intact.FIGURE 5. After the joint has been prepared and reamed, it is substantially decompressed and a full arc of motion is easily achieved.