Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 1;44(3):179-183.
doi: 10.1097/BPO.0000000000002580. Epub 2023 Nov 24.

Great Toe Interphalangeal Fusion for Hallux Valgus Interphalangeus Deformity in Young Patients

David E Westberry  1 , Emily R Shull  1 , Branum Layton  2
Affiliations

Great Toe Interphalangeal Fusion for Hallux Valgus Interphalangeus Deformity in Young Patients

David E Westberry et al. J Pediatr Orthop. .

Abstract

Objectives: The purposes of this study were to examine indications, radiographic outcomes, and clinical complications for primary arthrodesis of the great toe interphalangeal (IP) joint in young patients.

Background: Hallux valgus interphalangeus deformity of the great toe is uncommon in the pediatric population and often requires fusion of the IP joint.

Methods: A retrospective review of patients, ages 8 to 19 years, who underwent operative fusion of the great toe IP joint, and had >1 year radiographic follow-up was performed. Medical records and radiographs were reviewed to determine indications for surgery, concomitant procedures, success of fusion, complications, and need for revision procedures or elective hardware removal. Differences between pre and postradiographic outcomes for the hallux valgus angle, IP angle, and intermetatarsal angle were analyzed.

Results: Twenty-seven patients (31 feet) were included in the analyses. The average age at fusion surgery was 14.9 years (SD ± 2.3) with a mean follow-up visit of 35.2 months. The most common indications for fusion of the great toe IP joint were pain and deformity. Kirschner wire fixation was utilized in 7 cases, with the remaining 24 cases fixed with a single retrograde cannulated screw. Fifty-five concomitant toe and foot procedures were performed in 21 feet (68%) to address additional foot and toe deformity. Successful fusion occurred in 30 of 31 toes after the primary fusion. Patient satisfaction with the toe position and diminished pain were high (94.1%). Significant improvement was noted in the measure of the IP angle ( P < 0.001), with minimal clinical change in the hallux valgus angle ( P = 0.24) or the intermetatarsal angle ( P = 0.03).

Conclusions: Hallux valgus interphalangeus of the great toe was successfully managed with the fusion of the IP joint. Single screw fixation or the use of Kirschner wires led to similar outcomes. Hardware-related issues with the use of screws were the most common adverse outcome. Patients should be made aware of the possible need for hardware removal after fusion utilizing screw fixation.

Level of evidence: Level IV-a retrospective case series.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Arnold H. The Akin procedure as closing wedge osteotomy for the correction of a hallux valgus interphalangeus deformity. Oper Orthop Traumatol. 2008;20:477–483.
    1. Señarís-Rodríguez J, Martínez-Serrano A, Rodríguez-Durantez JA, et al. Surgical treatment for bunions in adolescents. J Pediatr Orthop B. 1998;7:210–216.
    1. Göksel F, Ermutlu C, Gölge UH, et al. Treatment of juvenile hallux valgus interphalangeus with a double compression headless bone screw. BMJ Case Rep. 2015;2015:bcr2015210204.
    1. Sharon SM, McClain J. An alternative fixation technique when performing hallux interphalangeal joint fusions. J Foot Surg. 1985;24:132–135.
    1. Shives TC, Johnson KA. Arthrodesis of the interphalangeal joint of the great toe-an improved technique. Foot Ankle. 1980;1:26–29.

LinkOut - more resources