Background
Definition
Bunion
- medial prominence of head of 1st MT
Hallux Valgus
- medial deviation 1st MT
- lateral deviation of great toe
Anatomy
Metatarsal head
- has 2 grooves separating ridge (cristae)
Bunion
- medial prominence of head of 1st MT
Hallux Valgus
- medial deviation 1st MT
- lateral deviation of great toe
Metatarsal head
- has 2 grooves separating ridge (cristae)
Able to achieve relatively high level of function after STJ fusion
- previously believed that isolated STJ fusion should not be performed
- believed that triple arthrodesis was operation of choice for hindfoot
- STJ fusion has superior result with less stress on AJ
Average loss of DF 30% / PF 10%
Position of hindfoot determines flexibility of transverse tarsal (CCJ & TNJ) joints
- imperative that fusion be positioned in ~ 5o valgus
- 90% load through plafond to talus
- 10% load through lateral talofibular articulation
A. Lateral Ligament Complex
ATFL (Anterior Talo-Fibular Ligament)
- tight in plantar flexion