Use of the Mini TightRope® for correction of hallux varus deformity

The flexible form of acquired hallux varus has historically been treated with a number of applicable soft tissue procedures, most of which combine medial capsular release with adjunct procedures aimed at restoring the transverse plane balance of the digit. In this report, a surgical technique for correction of hallux varus that employs the use of an implanted button and suture device, namely the Mini TightRope(®), is described. Rather than relying on the patient's own soft tissues, this device applies tension to anchor the hallux in the proper alignment. The device is easily adjusted during the course of the surgery and readily enables accurate correction of the hallux in the transverse plane. The indications, technical execution, postoperative care, and potential complications related to our use of the Mini TightRope(®) for correction of hallux varus are described, and the case of an adult woman who underwent the procedure for correction of acquired hallux varus is presented. In the authors' experience, the Mini TightRope(®) is a viable option that mimics restoration of the lateral collateral ligaments of the first metatarsophalangeal joint, and we believe this technique to be superior to other soft tissue surgical procedures used to repair flexible hallux varus.