HALLUX-VALGUS REPAIR - THE DISTAL SOFT-TI SSUE PROCEDURE AND PROXIMALMETATARSAL OSTEOTOMY

Correction of the hallux valgus deformity is dependent upon recognitio n of the specific anatomic deformity, followed by selection of a proce dure that addresses the specific deformity. A hallux valgus deformity with a subluxated metatarsophalangeal joint has a soft tissue and bony component, both of which need to be corrected, or a recurrence may re sult. The distal soft tissue procedure addresses the lateral soft tiss ue contracture by releasing the adductor hallucis, lateral joint capsu le and transverse metatarsus ligament. The capsule is medially elongat ed and the medial eminence needs to be excised. When metatarsus adduct us is present, a proximal metatarsal osteotomy should be carried out t o correct the bony deformity. If the intermetatarsal angle is not corr ected adequately, a recurrence of the hallux valgus is likely since a soft tissue procedure alone could not be expected to correct the bony deformity created by the increased intermetatarsal angle. Postoperativ ely the correction needs to be supported with a firm compression dress ing for 8 weeks to be sure the corrected alignment is maintained until healing of the soft tissues and osteotomy occurs.