Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus Deformity

The medial and lateral metatarsosesamoid suspensory ligaments together with the sesamoid apparatus are the main contributors to the rotational stability of the first metatarsophalangeal joint (MTPJ). Rotational instability of first MTPJ is a major factor in the development of hallux valgus and varus...

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Main Authors: Charles Churk Hang Li, M.B.Ch.B., F.H.K.C.O.S., F.H.K.A.M., Tun Hing Lui, M.B.B.S. (H.K.), F.R.C.S. (Edin.), F.H.K.A.M., F.H.K.C.O.S., Amanda Mun Yee Slocum, M.B.B.S. (H.K.), F.R.C.S.Ed. (Orth.), F.H.K.A.M., F.H.K.C.O.S.
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Arthroscopy Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2212628724004432
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author Charles Churk Hang Li, M.B.Ch.B., F.H.K.C.O.S., F.H.K.A.M.
Tun Hing Lui, M.B.B.S. (H.K.), F.R.C.S. (Edin.), F.H.K.A.M., F.H.K.C.O.S.
Amanda Mun Yee Slocum, M.B.B.S. (H.K.), F.R.C.S.Ed. (Orth.), F.H.K.A.M., F.H.K.C.O.S.
author_facet Charles Churk Hang Li, M.B.Ch.B., F.H.K.C.O.S., F.H.K.A.M.
Tun Hing Lui, M.B.B.S. (H.K.), F.R.C.S. (Edin.), F.H.K.A.M., F.H.K.C.O.S.
Amanda Mun Yee Slocum, M.B.B.S. (H.K.), F.R.C.S.Ed. (Orth.), F.H.K.A.M., F.H.K.C.O.S.
author_sort Charles Churk Hang Li, M.B.Ch.B., F.H.K.C.O.S., F.H.K.A.M.
collection DOAJ
description The medial and lateral metatarsosesamoid suspensory ligaments together with the sesamoid apparatus are the main contributors to the rotational stability of the first metatarsophalangeal joint (MTPJ). Rotational instability of first MTPJ is a major factor in the development of hallux valgus and varus deformities. As the great toe starts to rotate, the muscle pulls across the first MTPJ, causing it to become imbalanced and lead to progressive medial or lateral deviation of the great toe. The gold standard and most reliable option for hallux varus deformity is first MTPJ fusion. However, it results in stiffness and loss of joint function and is reserved for arthritic and stiff first MTPJ. Flexible iatrogenic hallux varus is corrected by optimally anatomic ligament reconstruction. The purpose of this Technical Note is to describe the details of arthroscopically assisted reconstruction of lateral metatarsosesamoid suspensory and lateral metatarsophalangeal collateral ligaments in management of iatrogenic hallux varus deformity. We reconstruct the lateral metatarsosesamoid suspensory ligament to restore the rotational stability of the first MTPJ in hallux varus deformity. This together with reconstruction of the lateral metatarsophalangeal collateral ligament anatomically corrects both the medial deviation and rotation deformity of the great toe.
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spelling doaj-art-279d39a5b3bc46a298bdd0f9da64a03a2025-08-20T03:14:02ZengElsevierArthroscopy Techniques2212-62872025-04-0114410329010.1016/j.eats.2024.103290Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus DeformityCharles Churk Hang Li, M.B.Ch.B., F.H.K.C.O.S., F.H.K.A.M.0Tun Hing Lui, M.B.B.S. (H.K.), F.R.C.S. (Edin.), F.H.K.A.M., F.H.K.C.O.S.1Amanda Mun Yee Slocum, M.B.B.S. (H.K.), F.R.C.S.Ed. (Orth.), F.H.K.A.M., F.H.K.C.O.S.2and Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, ChinaDepartment of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, New Territories, Hong Kong SAR, China; Address correspondence to Tun Hing Lui, M.B.B.S. (H.K.), F.R.C.S. (Edin.), F.H.K.A.M., F.H.K.C.O.S., Department of Orthopaedics and Traumatology, North District Hospital, 9 Po Kin Rd., Sheung Shui, NT, Hong Kong SAR, China.Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, New Territories, Hong Kong SAR, ChinaThe medial and lateral metatarsosesamoid suspensory ligaments together with the sesamoid apparatus are the main contributors to the rotational stability of the first metatarsophalangeal joint (MTPJ). Rotational instability of first MTPJ is a major factor in the development of hallux valgus and varus deformities. As the great toe starts to rotate, the muscle pulls across the first MTPJ, causing it to become imbalanced and lead to progressive medial or lateral deviation of the great toe. The gold standard and most reliable option for hallux varus deformity is first MTPJ fusion. However, it results in stiffness and loss of joint function and is reserved for arthritic and stiff first MTPJ. Flexible iatrogenic hallux varus is corrected by optimally anatomic ligament reconstruction. The purpose of this Technical Note is to describe the details of arthroscopically assisted reconstruction of lateral metatarsosesamoid suspensory and lateral metatarsophalangeal collateral ligaments in management of iatrogenic hallux varus deformity. We reconstruct the lateral metatarsosesamoid suspensory ligament to restore the rotational stability of the first MTPJ in hallux varus deformity. This together with reconstruction of the lateral metatarsophalangeal collateral ligament anatomically corrects both the medial deviation and rotation deformity of the great toe.http://www.sciencedirect.com/science/article/pii/S2212628724004432
spellingShingle Charles Churk Hang Li, M.B.Ch.B., F.H.K.C.O.S., F.H.K.A.M.
Tun Hing Lui, M.B.B.S. (H.K.), F.R.C.S. (Edin.), F.H.K.A.M., F.H.K.C.O.S.
Amanda Mun Yee Slocum, M.B.B.S. (H.K.), F.R.C.S.Ed. (Orth.), F.H.K.A.M., F.H.K.C.O.S.
Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus Deformity
Arthroscopy Techniques
title Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus Deformity
title_full Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus Deformity
title_fullStr Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus Deformity
title_full_unstemmed Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus Deformity
title_short Arthroscopically Assisted Reconstruction of Lateral Metatarsosesamoid Suspensory and Lateral Metatarsophalangeal Collateral Ligaments in the Management of Iatrogenic Hallux Varus Deformity
title_sort arthroscopically assisted reconstruction of lateral metatarsosesamoid suspensory and lateral metatarsophalangeal collateral ligaments in the management of iatrogenic hallux varus deformity
url http://www.sciencedirect.com/science/article/pii/S2212628724004432
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