PMC8564200_01
Preoperative appearance (a) and plain radiograph in the standing position (b). The hallux valgus angle was -24  and the intermetatarsal angle 0 .
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fig1
Her right foot exhibited a hallux varus deformity, and the second and third toes were dislocated dorsally (Figure 1(a)). On plain radiographs, the hallux valgus angle was -24 , and the IMA was 0  (Figure 1(b)).
Preoperative CT images. (a) 3DCT image. (b) Coronal image. Arrow indicates decreasing the surface area of the medial side of the articular surface at the first metatarsal head by resection of the bony prominence. (c) Dorsal dislocation of the 2nd toe. CT: computed tomography; 3DCT: three-dimensional computed tomography.
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fig2
Three-dimensional computed tomography (3DCT) revealed the hallux varus deformity and dorsal dislocation of the second toe (Figure 2(a)). On the coronal image, the surface area of the medial side of the articular surface at the first metatarsal head was decreased by the resection of the bony prominence (Figure 2(b)).
Schema of the surgical procedure.
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fig3
To correct the hallux varus deformity after the proximal osteotomy, we planned three steps, namely, correction of the IMA by corrective arthrodesis of the TMT joint, a shortening osteotomy of the second metatarsal bone, and reconstruction of the LCL of the first MTP joint (Figure 3).
Appearance of the foot (a) and active motion of the great toe at one year postoperatively. (b) Dorsiflexion. (c) Plantarflexion.
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fig4
The hallux valgus deformity had improved to the extent that she could wear commercial shoes without difficulty (Figure 4(a)). The ROM of the first MTP joint was 65  in dorsiflexion and 15  in plantarflexion (Figures 4(b) and 4(c)).
Radiograph one year postoperatively. The hallux valgus angle was 4  and the intermetatarsal angle 8 .
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fig5
Radiographic findings showed that the hallux valgus angle had corrected from -24  to 4 , and the IMA had corrected from 0  to 8  (Figure 5).