Function after correction of a clawed great toe by a modified Robert Jonestransfer

We carried out a cross-sectional study in 51 patients (81 feet) with a claw ed hallux in association with a cavus foot after a modified Robert Jones te ndon transfer, The mean follow-up was 42 months (9 to 88), In all feet, con comitant procedures had been undertaken, such as extension osteotomy of the first metatarsal and transfer of the tendon of the peroneus longus to pero neus brevis, to correct the underlying foot deformity. All patients were ev aluated clinically and radiologically. The overall rate of patient satisfaction was 86%. The deformity of the hall ux was corrected in 80 feet. Catching of the big toe when walking barefoot, transfer lesions and metatarsalgia, hallux flesus, hallux limitus and asym ptomatic nonunion of the interphalangeal joint were the most frequent compl ications. Hallux limitus was more likely when elevation of the first ray oc curred (p = 0.012). Additional transfer of the tendon of peroneus longus to peroneus brevis was a significant risk factor for elevation of the first m etatarsal (p < 0.0001). The deforming force of extensor hallucis longus is effectively eliminated b y the Jones transfer, but the mechanics of the first metatarsophalangeal jo int are altered. The muscle balance and stability of the entire first ray s hould be taken into consideration in the management of clawed hallux.