The congenital hallux varus

Introduction: The congenital hallux varus is a rare hereditary deformity of the big toe, which often is combined either with polydactylia or with syst emic deformities of the skeleton. The congenital hallux varus can be easily diagnosed clinically. The X-ray shows the ossified bony elements and provi des information about the shape and number of the digits as well as their a xial deviation. An operative treatment is required. So far a standardized s urgical technique has not been accepted for all types of hallux varus. Methods: The correction of the bony structures and soft tissues is planned by means of preoperative scetches. The amount of correction depends on the degree of the deformity. As consequence of the reorientation of the first r ay a soft tissue nap has to be planned and prepared for wound closure which otherwise would need larger grafts. Results: Based on this series the clinical and radiological appearance of t he congenital hallux varus are discussed. The operative treatment is explai ned step by step illustrated by photographs as well as planing scetches. Ou r procedures are compared to other operative methods reported in the litera ture. Conclusions: There are no diagnostic problems with the hallux varus deformi ty. For therapy surgery is mandatory and recommended between 9 and 24 month s of age. For microsurgical preparation and correction of the deformity pla nning of all surgical steps and alternatives is advocated, this allows for good functional and cosmetic results.