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35-year-old female with a 20 degree HVA, a 11 degree IMA, and an incongruent 1st MTP joint
61%
1787/2926
40-year-old male with a 30 degree HVA, and a 15 degree IMA, and a congruent 1st MTP joint
25%
744/2926
70-year-old female with a 35 degree HVA, and a 13 degree IMA with a hypermobile 1st ray
6%
172/2926
65-year-old female with a 25 degree HVA, a 14 degree IMA, and severe hallux rigidus
3%
98/2926
85-year old minimally ambulatory male with a 45 degree HVA, and a 20 degree IMA
100/2926
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The Modified McBride procedure is indicated in patients 30-50 years old with an incongruent joint, a HVA less than 25 degrees, and an IMA deformity less than 15 degrees. This soft tissue procedure should be avoided in moderate or severe hallux valgus deformity due to the increased risk of recurrence. Surgical technique includes release of adductor hallucis, transverse metatarsal ligament, and lateral capsule combined with excision of medial eminence and plication of the capsule medially. In patients with moderate hallux valgus deformity (HVA 26-40 deg, IMA 13-15 deg) a proximal osteotomy should be performed. In patients with moderate deformity and a hypermobile 1st ray, a Lapidus procedure (includes 1st TMT fusion) should be considered. A MTP arthodesis is indicated when concomitant severe hallux rigidus is present, and a Keller (includes partial resection of proximal phalanx) procedure should be considered in an elderly, low demand individual with severe deformity. Illustration A is an AP radiograph of the foot demonstrating the technique used in measuring the HVA and IMA.
2.8
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