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Forty-two examples of elevation of the first metatarsal with hallux equinus have been reviewed. The modes of production and methods of prevention and operative correction of the deformity are presented.
The deformity is caused by a muscular imbalance of the foot which is the result of various primary diseases. An imbalance of muscles acting upon the first metatarsal caused the deformity in 86 per cent of the cases while 14 per cent were the results of muscular imbalance of the great toe.
The primary disease was anterior poliomyelitis in 64 per cent of the examples. Tendon transference accounted for the deformity in 70 per cent of the cases in this group (45 per cent of the total series). Before transference of the peroneus longus tendon careful consideration should be directed to the effect of such transference upon the first metatarsal. This tendon should not be transferred to the region of insertion of the anterior tibial tendon nor should it be transferred to the os calcis without regard for a strong anterior tibial muscle.
The results of operative correction of this deformity have been relatively good.
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- “Dorsal Bunion”: Its Mechanics and Operative Correction.J. Bone and Joint Surg. 1940; 22: 627-637
Received: June 13, 1942
© 1943 Published by Elsevier Inc.