eMedicine Specialties > Orthopedic Surgery > Foot & Ankle

Hallux Varus: Workup

Author: Amy Jo Ptaszek, MD, Assistant Professor, Department of Orthopedic Surgery, University of Texas Southwestern Medical Center
Contributor Information and Disclosures

Updated: Mar 10, 2009

Workup

Laboratory Studies

  • Order laboratory studies that are applicable to the specific patient.
  • If infection is suspected, obtain the following indices:
    • Erythrocyte sedimentation rate (ESR)
    • C-reactive protein (CRP)
    • White blood cell (WBC) count
  • Joint aspiration may also be indicated. If inflammatory disease is suspected, obtain rheumatoid arthritis (RA) and antinuclear antibody (ANA) factors.

Imaging Studies

  • Weight-bearing radiographs of both feet, including anteroposterior, lateral, and sesamoid views, help clinicians to assess the degree of varus, the IM and IP angles, the position of the sesamoids relative to the metatarsal head, and any degenerative changes in the MTP and/or IP joints.

More on Hallux Varus

Overview: Hallux Varus
Workup: Hallux Varus
Treatment: Hallux Varus
Follow-up: Hallux Varus
Multimedia: Hallux Varus
References
Further Reading
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References

  1. Jahss MH. Disorders of the hallux and first ray. Disorders of the Foot and Ankle: Medical and Surgical Management. 2nd ed. Philadelphia, Pa: WB Saunders Co; 1991:1084-9.

  2. Miller JW. Acquired hallux varus: a preventable and correctable disorder. J Bone Joint Surg Am. Mar 1975;57(2):183-8. [Medline]. [Full Text].

  3. Granberry WM, Hickey CH. Idiopathic adult hallux varus. Foot Ankle Int. Apr 1994;15(4):197-205. [Medline].

  4. Orzechowski W, Dragan S, Romaszkiewicz P, Krawczyk A, Kulej M, Morasiewicz L. Evaluation of follow-up results of McBride operative treatment for hallux valgus deformity. Ortop Traumatol Rehabil. May-Jun 2008;10(3):261-73. [Medline].

  5. Popelka S, Vavrík P, Hromádka R, Sosna A. [Our results of the Lapidus procedure in patients with hallux valgus deformity]. Acta Chir Orthop Traumatol Cech. Aug 2008;75(4):271-6. [Medline].

  6. Lagaay PM, Hamilton GA, Ford LA, Williams ME, Rush SM, Schuberth JM. Rates of revision surgery using Chevron-Austin osteotomy, Lapidus arthrodesis, and closing base wedge osteotomy for correction of hallux valgus deformity. J Foot Ankle Surg. Jul-Aug 2008;47(4):267-72. [Medline].

  7. Mann RA, Coughlin MJ, eds. Adult hallux valgus. Surgery of the Foot and Ankle. 6th ed. St. Louis, Mo: Mosby, Inc; 1993:284-92.

  8. Leemrijse T, Hoang B, Maldague P, Docquier PL, Devos Bevernage B. A new surgical procedure for iatrogenic hallux varus: reverse transfer of the abductor hallucis tendon: a report of 7 cases. Acta Orthop Belg. Apr 2008;74(2):227-34. [Medline].

  9. Hawkins FB. Acquired hallux varus: cause, prevention and correction. Clin Orthop Relat Res. May 1971;76:169-76. [Medline].

  10. Johnson KA, Spiegl PV. Extensor hallucis longus transfer for hallux varus deformity. J Bone Joint Surg Am. Jun 1984;66(5):681-6. [Medline]. [Full Text].

  11. Skalley TC, Myerson MS. The operative treatment of acquired hallux varus. Clin Orthop Relat Res. Sep 1994;(306):183-91. [Medline].

  12. Myerson MS, Komenda GA. Results of hallux varus correction using an extensor hallucis brevis tenodesis. Foot Ankle Int. Jan 1996;17(1):21-7. [Medline].

  13. Juliano PJ, Myerson MS, Cunningham BW. Biomechanical assessment of a new tenodesis for correction of hallux varus. Foot Ankle Int. Jan 1996;17(1):17-20. [Medline].

  14. Tourné Y, Saragaglia D, Picard F, et al. Iatrogenic hallux varus surgical procedure: a study of 14 cases. Foot Ankle Int. Aug 1995;16(8):457-63. [Medline].

  15. Tanaka Y, Takakura Y, Kumai T, Sugimoto K, Taniguchi A, Hattori K. Proximal spherical metatarsal osteotomy for the foot with severe hallux valgus. Foot Ankle Int. Oct 2008;29(10):1025-30. [Medline].

  16. Chow FY, Lui TH, Kwok KW, Chow YY. Plate fixation for crescentic metatarsal osteotomy in the treatment of hallux valgus: an eight-year followup study. Foot Ankle Int. Jan 2008;29(1):29-33. [Medline].

  17. Sanders M. Complications of hallux valgus surgery. Complications of Foot and Ankle Surgery. 1998:1-18.

  18. Vanore JV, Christensen JC, Kravitz SR, et al. Diagnosis and treatment of first metatarsophalangeal joint disorders. Section 3: hallux varus. J Foot Ankle Surg. May-Jun 2003;42(3):137-42. [Medline].

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Keywords

hallux varus, medial deviation of the great toe, flexible hallux varus, hallux valgus, congenital hallux varus, primary dynamic infantile hallux varus, traumatic hallux varus, idiopathic hallux varus, first metatarsophalangeal joint arthrodesis, MTP arthrodesis, intermetatarsal angle, IM angle

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Contributor Information and Disclosures

Author

Amy Jo Ptaszek, MD, Assistant Professor, Department of Orthopedic Surgery, University of Texas Southwestern Medical Center
Amy Jo Ptaszek, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Foot and Ankle Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

John S Early, MD, Foot/Ankle Specialist, Texas Orthopaedic Associates, LLP; Co-Director, North Texas Foot and Ankle Fellowship Baylor University Medical Center
John S Early, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Medical Association, American Orthopaedic Foot and Ankle Society, Orthopaedic Trauma Association, and Texas Medical Association
Disclosure: Zimmer Inc Consulting fee Independent contractor; Smith Nephew Consulting fee Independent contractor; AO North America Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Shepard R Hurwitz, MD, Executive Director, American Board of Orthopaedic Surgery
Shepard R Hurwitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association for the Advancement of Science, American College of Rheumatology, American College of Sports Medicine, American College of Surgeons, American Diabetes Association, American Orthopaedic Association, American Orthopaedic Foot and Ankle Society, Association for the Advancement of Automotive Medicine, Eastern Orthopaedic Association, Orthopaedic Research Society, Orthopaedic Trauma Association, and Southern Orthopaedic Association
Disclosure: Nothing to disclose.

CME Editor

Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital
Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Physicians of Indian Origin, American College of International Physicians, and American College of Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Jason H Calhoun, MD, FAAOS, Chairman, J Vernon Luck Distinguished Professor, Department of Orthopedic Surgery, University of Missouri
Jason H Calhoun, MD, FAAOS is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American College of Surgeons, and American Orthopaedic Foot and Ankle Society
Disclosure: Nothing to disclose.

 
 
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