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SURGERY - Assess & Classify Deformity Radiographic Findings * "Staking" of 1st Metatarsal * Negative HA Angle * Absence of Fibular Sesamoid * Negative IM Angle * Medial Displacement of Tibial Sesamoid * Long 1st Metatarsal * Presence of DJD * IP Flexion * MTP Joint Extension Significant Findings: * Medial Deviation of Great Toe * Long Hallux / 1st Ray * IPJ Bursitis * Loss of Hallux Purchase Significant History: * Previous Surgery * Difficulty Fitting Shoes * Pain wearing Shoes * Progressive Deformity * Cosmetic Complaints ETIOLOGY 1. Post-Surgery 2. Arthritides 3. Congenital 4. Neuromuscular 5. Trauma Associated Findings * Lesser Toe Adductus * Compensatory Hindfoot Supination * Medial Ingrown Toenail Other Etiologies * Diagnose & Treat Appropriately Treatment Options POST SURGICAL HALLUX VARUS * Duration Dependent LATER * Shoe Modifications * Wider Shoes / Higher Toe Box * Surgery, See Section 2, Fig 7 EARLY * Postoperative Splinting * Clinical & Radiographic Monitoring * Continued Symptoms or Progression of Deformity, Consider Surgery, see Section 2, Fig 7 Type 1 MTP Joint Adduction Type 2 Adduction + IPJ Flexion Type 3 Complex Multiplane * MTP Adduction & Extension * IPJ Flexion * Hallucal Rotation * Non-Reducible 2B Pain on ROM 2A Painfree ROM 1B Pain on ROM 1A Painfree ROM See Table 1 for Procedure(s) to Address Various Segments of Deformity Pathway 4 All copyrights are reserved by the Academy of Ambulatory Foot and Ankle Surgery. Hallux Varus Source: Clinical Practice Guideline First Metatarsophalangeal Joint Disorders Panel. Diagnosis and treatment of first metatarsophalangeal joint disorders. J Foot Ankle Surg 2003 May-Jun;42(3):112-54.