Review Question - QID 218601

A 56-year-old healthy female presents to your office complaining of a painful toe deformity. She reports having had bunion surgery one year ago with another surgeon, who performed a distal chevron osteotomy, akin osteotomy, and several other adjunct procedures. On examination, there is a varus deformity noted at the metatarsophalangeal joint with loss of motion. Pain is worse with walking and when she wears closed-toed shoes. Which of the following represents the most likely cause of her deformity?