John M. Schuberth, DPM, FACFAS
Chief, Foot and Ankle Surgery
Kaiser Foundation Hospital
Dr. John Schuberth discusses the Mortal Sins that can be committed
while performing correction of Hallux Abducto Valgus deformities. One wrongdoing
is usually forgiven, yet two or more result in the misfortune known as Hallux
Varus. What are these grave transgressions?
Over correction of the Intermetatarsal Angle
Spiking the Head of the 1st Metatarsal
Patients typically undergo Hallux Valgus Surgery to repair a painful deformity
which may also be cosmetically unacceptable to them. Should their repair result
in a Hallux Varus deformity, they will be invariably perturbed. "Shoes are not
made for feet with reverse contours of the digits", says Dr. Schuberth. To add
insult to injury, these patients tend to develop a morbid gait.
Dr. Schuberth reviews the deformity in great detail. A negative hallux abductus
angle is probably the most consistent finding. Commonly, the intermetatarsal
angle is negative and the 1st MPJ is incongruous.
As the deformity progresses, migration of the lesser toes occurs. Dr. Schuberth
describes the "tie-bar phenomenon"
Examples of Hallux Flexus and 1st MPJ Arthrosis are given.
Dr. Schuberth reviews the anatomy of the 1st MPJ and describes the repair of
Included in this lecture is a case presentation by Dr. Marc Dolce.
We see less and less Hallux Varus today, because we have a better understanding
of the causes of this complication.
FYI: We can look forward to hearing Dr. Schuberth present a lecture on board
review preparation in the very near future.