Review Topic
  • Epidemiology
    • presents in children after walking age
  • Pathophysiology
    • deformity at metatarsophalangeal joint due to 
      • imbalance between the great toe abductor and adductors
    • pathoanatomy
      • firm, fibrous, band-like abductor hallucis muscle
      • short, thick first metatarsal
      • longitudinal bracket epiphysis of the 1st metatarsal
      • underlying skeletal dysplasia (diastrophic dwarfism)
    • do not confuse with metatarus primus varus
      • varus deformity of the 1st metatarsal (no deformity at MTP joint)
  • Risk factors
    • longitudinal epiphyseal bracket of the first metatarsal or proximal phalanx
  • Associated conditions
    • often associated with polydactyly
  • Symptoms
    • cosmetic deformity
      • difficult to put on shoes
      • usually painless
  • Deformity
    • can vary in severity
      • few degrees to 90 degress
  • Radiographs
    • recommended views of the foot
      • AP
      • lateral
      • oblique
    • findings
      • short, thick 1st metatarsal 
  • Must be differentiated from metatarsus adductus
  • Nonoperative
    • observation alone
      • indication
        • rare as deformity is thought to worsen with age
        • surgical correction often proposed in infancy
  • Operative
    • abductor hallucis muscle release
      • indication
        • mild and resistant deformities
    • excision of central portion of epiphyseal bracket 
      • indication
        • if epiphyseal bracket found to be the cause of Hallux Varus
      • resumption of longitudinal growth common if performed at a young age
      • secondary corrective realignment or lengthening is sometimes needed
    • Farmer technique 
      • indication
        • moderate to severe deformities
      • technique creates syndactyly between the 2nd toe and hallux
      • maintains deformity correction
  • Recurrence of deformity
  • Incomplete correction of deformity

Please rate topic.

Average 2.8 of 10 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Topic COMMENTS (11)
Private Note