Behandlungsstrategien bei Hallux valgus Rezidiv

Hallux valgus recurrence is defined as valgus deviation of the great toe of 20° or more to the lateral side after hallux valgus surgery. Hallux valgus recurrence is usually associated to a recurrent medial deviation of the first metatarsal. Before any secondary operative correction, a systematic analysis of the components of the deformity and the entire foot is mandatory. The first step in the decision for secondary correction is to decide whether joint preserving surgery of the metatarsophalangeal joint is possible and advisable. Otherwise a mtp-1-arthrodese is a viable option that leads to a stable foot with minor functional limitations. If joint preserving surgery is chosen, a systematic correction of all aspects of the deformity from proximal to distal should be conducted. A Lapidus arthrodesis of the first tarsometatarsal joint is usually one of the key components of any secondary correction and can be combined with additional procedures like correction of the distal metatarsal orientation by a biplanar Chevron osteotomy and correction of the toe through an Akin osteotomy.