Management of neglected congenital hallux varus in a 13 year old boy: A case report

Abstract

Introduction: Congenital hallux varus is a rare condition. Primary congenital hallux varus results because of over activity of adductor halluces whereas secondary congenital hallux varus results due to various conditions like polydactyl, metatarsus bracket and metatarsus adducts. Acquired hallux varus results due to damage to articular cartilage and lax collateral ligaments seen in inflammatory arthropathies like psoriasis, rheumatoid arthritis and trauma. Treatment of neglected congenital hallux varus in adult is challenging due to soft tissue contractures and rigid bony deformities.Case report: We present here a case of a 13 years old male patient who presented to outpatient department of SDM Medical College Sattur, Dharwad – Karnataka with neglected congenital hallux varus of secondary type. Patient had an extra rudimentary great toe (polydactyl) which was obvious on radiographs. We have treated this patient by farmer`s procedure. Intra-operatively phalangeal, metatarsal and tarsal alignment was held with k-wire and post-operatively reduction maintained with specially formed splint. We have more than 14 month follow-up of indexed case. No recurrence of deformity was noted.Conclusion: Congenital hallux varus is a rare condition. Treatment of neglected congenital hallux varus is challenging due to soft tissue contractures and bony rigidity. Farmer`s procedure is an effective surgery to restore near normal anatomy, post-operative splint prevents recurrence of deformity.