Operative Techniques: Foot and Ankle Surgery

Arthroscopy of the Great Toe

Indications Loose bodies Hallux valgus: synovitis Hallux valgus: lateral release Turf toe: assessment of plantar plate Sesamoid to metatarsal head arthritis Gout Dorsal osteophytes Hallux rigidus Chondral defect Arthroscopic first metatarsophalangeal (MTP) fusion Synovitis Diagnostic arthroscopy for recurrent pain or…

Correction of Acquired Hallux Varus

Indications Pitfalls Hallux varus must be reducible. Malunion of the metatarsal or proximal phalanx may preclude a simple soft-tissue correction. A negative intermetatarsal angle may require correction. Consider a fusion for an arthritic joint. Indications Controversies There are no long-term…

Revision Hallux Valgus Surgery

Indications Ongoing pain symptomatic enough to merit surgery Recurrent hallux valgus deformity Second metatarsalgia or overload Elevated first ray Plantar flexed first ray Hallux varus Avascular necrosis of the first metatarsal (MT) head Nonunion of osteotomy or arthrodesis Indications Pitfalls…

Scarf Osteotomy for Correction of Hallux Valgus

Indications Objective Indications Moderate to severe hallux valgus deformities with Increased hallux valgus angle (HVA) ≤50° Increased intermetatarsal angle (IMA) ≤20° Increased distal metatarsal articular angle (DMAA) ≤10° Hallux valgus revision surgery for recurrence (Bock, 2009) Bunionette deformity of fifth…

Hallux Valgus Correction With Modified Chevron Osteotomy

Indications Painful hallux valgus deformity Failure of shoe modification Symptoms that interfere with daily activities A mild to moderate deformity (hallux valgus angle <30º; intermetatarsal angle [IMA] <13–15°) Patients with a high distal metatarsal articular angle (DMAA) require a chevron…