Gradual Correction of Traumatic Hallux Varus With Metatarsal Hemicallotasis

J Foot Ankle Surg. 2016 Mar-Apr;55(2):283-7. doi: 10.1053/j.jfas.2014.07.018. Epub 2014 Sep 7.

Abstract

Traumatic hallux varus associated with osseous deformity, especially in the case of a decreased distal metatarsal articular angle, is an extremely challenging, but rewarding, deformity to treat. To the best of our knowledge, no previous reports have referred to surgical correction of traumatic hallux varus using first metatarsal hemicallotasis. We report the case of a 54-year-old male with traumatic hallux varus associated with medial subluxation of the second metatarsophalangeal joint and second metatarsocuneiform joint arthrosis. The patient was successfully treated with metatarsal hemicallotasis with medial soft tissue release, a proximal second metatarsal shortening osteotomy, and second metatarsocuneiform joint arthrodesis. After 1 year and 6 months, the correction had been maintained in a suitable position, no discomfort or pain was present, and the patient was completely satisfied with the surgical results. Metatarsal hemicallotasis can safely determine the angle of correction and minimize the risk of avascular necrosis of the metatarsal head even in deformed halluces with previous traumatic injuries and/or surgical treatment. This technique should be indicated only for hallux varus with a decreased distal metatarsal articular angle, an angular-type metatarsal head, and good metatarsophalangeal joint congruence.

Keywords: 4; callus distraction; deformity correction; external fixator; great toe; metatarsal.

Publication types

  • Case Reports

MeSH terms

  • Foot Deformities, Acquired / diagnostic imaging
  • Foot Deformities, Acquired / etiology
  • Foot Deformities, Acquired / surgery*
  • Foot Injuries / complications
  • Foot Injuries / diagnostic imaging
  • Foot Injuries / surgery*
  • Hallux / diagnostic imaging
  • Hallux / injuries*
  • Hallux / surgery
  • Hallux Varus / diagnostic imaging
  • Hallux Varus / etiology
  • Hallux Varus / surgery*
  • Humans
  • Male
  • Metatarsal Bones / diagnostic imaging
  • Metatarsal Bones / injuries
  • Metatarsal Bones / surgery*
  • Middle Aged