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Correction of Hallux Valgus Using Lateral Soft-Tissue Release and Proximal Chevron Osteotomy Through a Medial Incision
Woo-Chun Lee, PhD, MD; Yu-Mi Kim, MD
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Oct 01;89(suppl 3):82-89. doi: 10.2106/JBJS.G.00483
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As the degree of hallux valgus increases, the lateral capsule of the first metatarsophalangeal joint and the adductor tendon become contracted. In most surgical procedures designed to correct moderate to severe degrees of hallux valgus, the soft-tissue structures on the lateral aspect of the first metatarsophalangeal joint need to be released in order to reduce the subluxated joint. There are two surgical approaches for lateral soft-tissue release for the correction of hallux valgus. One is the dorsal approach between the first and second metatarsals1-6, and the other is the medial approach, which passes under the first metatarsal head7-11. We think that a medial approach is cosmetically as well as functionally better because it does not create a dorsal scar, which can be unsightly (Figs. 1-A and 1-B), and because it is less likely to cause stiffness of the first or second metatarsophalangeal joint. It is, however, difficult to release the lateral soft tissues, including the adductor tendon and the capsule, through a medial incision because, in patients with hallux valgus, the lateral sesamoid is displaced laterally and dorsally. Thus, the dorsal approach between the first and second metatarsals is more widely used among foot surgeons.
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