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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia Del Piede 2001 June;25(2):105-32
Iatrogenic hallux varus. Correction methods with special reference to K. A. Johnson's technique
The subject of this study is the iatrogenic hallux varus understood as a deformity of the 1st radius of the foot which generally occurs as a result of corrective surgery for hallux valgus. The surgical correction of hallux varus varies according to age, sex, profession, possible sporting involvement, previous surgery, the duration of the deformity, the severity of varism and anatomopathological lesions. Hallux varus can be treated using 4 methods: ‹ surgery on teno-capsulo-ligamentous medial structures; ‹ skeletal surgery; ‹ prosthetic surgery; surgery involving the transposition of tendons.The author focuses in particular on the latter operations and gives a detailed description of the following techniques: K. A. Johnson's operation (1984) involving the transfer of the EPA on the lateral face of the base of the 1st phalanx of the hallux, and the modifications introduced by the author to Johnson's original technique. Johnson's modified operation can correct hallux varus of moderate severity. Seven cases of iatrogenic hallux varus were operated between 1989 and 1993. The results were very good in 6 cases and satisfactory in one. For severe and inveterate cases, arthrodesis of the 1st metatarsal-phalanx is still the ideal operation.