Lateral Collateral Ligament Reconstruction Using Suture-tape for Chronic Varus Metatarsophalangeal Instability of The Hallux

Reconstruction of the Lateral Collateral Ligament Using a Suture Tape Anchor for Iatrogenic Hallux Varus

“…Recently, joint stabilization techniques using artificial ligaments have been developed to achieve the reconstruction of the collateral ligament in various joint [7][8][9]. Cho et al demonstrated the stabilization of the first MTP joint in a patient with chronic varus instability using suture tape [17]. In their procedure, 2.7 mm bone tunnels were created at the proximal phalanx and the metatarsal bone under fluoroscopy, whereafter suture tape was fixed using the 3.0 mm biotenodesis screws with congruent reduction.…”

First Metatarsophalangeal Lateral Collateral Ligament Repair in an Athlete

“…More common, although still rare, are first MTP collateral ligament injuries in the context of a traumatic isolated dorsal MTP dislocation prompted by forceful hyperextension with or without a varus or valgus moment of the great toe 1,2 . Regardless of whether a successful reduction was performed after medial or dorsal dislocation of the first MTP joint, an incompetent lateral capsular or ligamentous complex that cannot resist the recurring varus force leaves the hallux susceptible to chronic varus instability or recurrent subluxation 3 . Surgical management for first MTP instability includes arthrodesis, plantar plate repair, collateral ligament repair, and collateral ligament reconstruction using allograft or autograft 4,5 .…”

“…Evidence-based surgical strategies to reconstruct the collateral ligament complex of the first MTP joint are not available 3,5,8 . We report a case of first MTP LCL insufficiency in a young, female gymnast with varus laxity and subsequent satisfactory mid-term and long-term outcomes.…”

“…An incompetent LCL complex that cannot resist varus force leaves the hallux susceptible to chronic varus instability, recurrent subluxation, and pain 3 . Nonoperative treatment consists of immobilization, taping, bracing, and physical therapy.…”

“…Surgical management for first MTP instability includes arthrodesis, plantar plate repair, collateral ligament repair, and collateral ligament reconstruction using allograft or autograft 4,5 . A reliable option for severe instability or pain relief is arthrodesis, although this joint sacrificing may not be ideal for young people or athletes 6,7 because motion at the first MTP joint is essential for pushoff power for running and jumping.Evidence-based surgical strategies to reconstruct the collateral ligament complex of the first MTP joint are not available 3,5,8 . We report a case of first MTP LCL insufficiency in a young, female gymnast with varus laxity and subsequent satisfactory mid-term and long-term outcomes.The patient and her parents were informed that data concerning the case would be submitted for publication, and they provided consent.…”