What is hallux varus?
Hallux varus is when the big toe points towards the inside of the foot (the big toe resembles a thumb). A person can be born with a hallux varus and it can occur as a complication after a bunion surgery. When the big toe points the other way it can make wearing closed toed shoes painful and makes wearing flip flop sandals nearly impossible.
How is hallux varus treated?
In children, hallux varus is best treated as soon as possible after birth. The deformity is usually flexible and can be manipulated and resolved with serial casting. Once the deformity has resolved, splinting is needed to prevent reoccurrence. If the hallux varus does reoccur or is resistant to casting, a tendon release may be performed after the child is one year old.
In the adult, there are several ways to treat a hallux varus complication after bunion surgery. A soft tissue release of the joint followed by using a non-absorbable suture to hold the toe in place is one option. Re-cutting the first metatarsal bone to shift it back over is another procedure used reposition the big toe. However, even after either of these procedures, a hallux varus may still reoccur.
The most reliable treatment of a hallux varus is to fuse the big toe joint. In this procedure, cartilage is removed from the joint surface and the joint is held together with screws until the bone grows together. Motion is traded for joint stability with a fusion. The recovery period is typically non-weightbearing for 6 weeks after this procedure.
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