Lesser Toe Alignment After Bunion Surgery

By Calvin J. Rushing, DPM

Hallux valgus deformity often presents with spectrum of concurrent pathology, including valgus (lateral) deviation of the lesser digits, termed “windswept deformity.” Historically, however, research has focused on deformity contracture in the sagittal plane.  

New research

Kang et al. observed that in 89 patients who had bunion correction surgery using proximal metatarsal/phalanx osteotomies (specifically, chevron/akin procedures), there was an average correction of 27 to 45% in the lesser digits' valgus deviation. This improvement was achieved without any additional procedures being performed at the same time.

The metatarsus adductus factor 

The primary factor influencing both the severity of the pre- and post-operative valgus deviation of the digits, as well as the risk for recurrence was metatarsus adductus, defined using the modified Sgarlato method.  

The Sgarlato method for deformity measurement has been shown to be reliable in the hallux valgus population.