A relatively new method to treat a bunion deformity by means of positional correction rather than structural realignment via osteotomy has been used in a series of 5 patients. This approach to first ray correction entails the use of an interosseous suture and button device that is positioned under tension between the first and second metatarsals, thereby reducing the first intermetatarsal angle. The median age of the group of patients was 51 years (range, 16-71 years), and the median follow-up duration was 20 months (range, 8-64 months). Statistically significant reductions in the first intermetatarsal and hallux abductus angles were observed between the preoperative and immediate postoperative measurements (P = .0006 and P = .0044, respectively) and between the preoperative and long-term postoperative measurements (P = .0189 and P = .0305, respectively), and, although loss of correction was observed between the immediate and long-term postoperative first intermetatarsal and hallux abductus angles, these changes were not statistically significant (P = .1369 and P = .1193, respectively). In 3 (60%) of the cases, complications developed that required revisional surgery and removal of the device. In the other 2 (40%) cases, the surgical procedure was modified and satisfactory outcomes were obtained, although minor complications occurred in both. Based on our experience with these patients, the modified surgical procedure shows some effectiveness in treating hallux abductovalgus, although further evaluation of the technique is warranted.
Level of Clinical Evidence
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- Hallux valgus: demographics, etiology, and radiographic assessment.Foot Ankle Int. 2003; 24: 731-743
Arthrex. Mini TightRope® For Hallux Valgus Correction and Lisfranc Ligament Repair: Surgical Technique. InStep Foot & Ankle Web site. http://www.instepfootandankle.com/files/34140216.pdf. Accessed October 19, 2009.
- Sling procedure for correction of splay-foot, metatarsus primus varus, and hallux valgus.J Bone Joint Surg Am. 1950; 32-A: 779-792
- A treatise on the McBride procedure: a review of the McBride publications on hallux valgus correction with observations on the rationale of the original procedure and the current modifications.J Am Podiatr Assoc. 1971; 61: 161-173
- Ligamentation of the adductor hallucis tendon in bunionectomy.J Am Podiatr Med Assoc. 2002; 92: 512-515
- The anatomic reconstruction of acriomioclavicular joint dislocations using 2 Tightrope devices: a biomechanical study.Am J Sports Med. 2008; 36: 2398-2406
- Treatment of syndesmotic disruptions with the Arthrex Tightrope: a report of 25 cases.Foot Ankle Int. 2008; 29: 773-780
- Technique tip: suture suspension of tendons.Foot Ankle Int. 2007; 28: 854-856
- Repair of distal biceps tendon rupture: a new technique using the Endobutton.J Shoulder Elbow Surg. 2000; 9: 120-126
- Comparison of a novel FiberWire-button construct versus metallic screw fixation in a syndesmotic injury model.Foot Ankle Int. 2008; 29: 49-54
- Suture-Endobutton fixation of the ankle tibio-fibular diastasis: a cadaver study.Foot Ankle Int. 2003; 24: 142-146
- Current concepts review: operative techniques for stabilizing the distal tibiofibular syndesmosis.Foot Ankle Int. 2007; 28: 1302-1308
- Syndesmosis procedure: a non-osteotomy approach to metatarsus primus varus correction.Foot Ankle Int. 2007; 28: 1000-1006
- Mann Award. The reliability of angular measurements in hallux valgus deformities.Foot Ankle Int. 2001; 22: 369-379
- The mechanics of the foot I. The joints.J Anat. 1954; 87: 345-357
- Measurement of first-ray mobility in normal vs. hallux valgus patients.Foot Ankle Int. 2001; 22: 960-964
- First ray dorsal mobility in relation to hallux valgus deformity and first intermetatarsal angle.Foot Ankle Int. 2001; 22: 98-101
- Clinical, quantitative assessment of first tarsometatarsal mobility in the sagittal plane and its relation to hallux valgus deformity.Foot Ankle Int. 1994; 15: 9-13
- Current concepts review: hallux valgus part 1: pathomechanics, clinical assessment, and nonoperative management.Foot Ankle Int. 2007; 28: 654-659
- Role of first ray hypermobility in the outcome of the hohmann and the lapidus procedure: a prospective, randomized trial involving one hundred and one feet.J Bone Joint Surg Am. 2004; 86-A: 486-495
- Clinical significance of increased mobility in sagittal plane in patients with hallux valgus.Foot Ankle Int. 1999; 20: 29-32
- Radiographic analysis of hallux valgus. A two-dimensional coordinate system.J Bone Joint Surg Am. 1995; 77-A: 205-213
- Hypermobility of the first metatarsal bone: the interlinking factor between metatarsalgia and longitudinal arch strains.J Bone Joint Surg Am. 1928; 10-A: 187-196
- Hallux valgus and first ray mobility: a prospective study.J Bone Joint Surg Am. 2007; 89-A: 1887-1898
- Hallux valgus and first ray mobility: a cadaveric study.Foot Ankle Int. 2004; 25: 537-544
- Clinical Biomechanics of the Lower Extremities.Mosby, St. Louis1996
- The windlass mechanism of the foot: a mechanical model to explain pathology.J Am Podiatr Med Assoc. 2000; 90: 35-46
- Metatarsal head motion secondary to rearfoot pronation and supination.J Am Podiatr Med Assoc. 1979; 69: 24-28
- Metatarsalgia: diagnosis and treatment.J Bone Joint Surg Am. 1980; 62-A: 723-732
Published online: November 11, 2009
Financial Disclosure: None reported.
Conflict of Interest: None reported.
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.