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Acquired Hallux Varus Deformity Correction: Pivotless Distraction Technique.

Yasim Khan¹, Sumit Arora², Dhananjaya Sabat³

¹*Maulana Azad Medical College, New Delhi, India.

Journal of the American Podiatric Medical Association

|September 16, 2023

Summary

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This study presents a novel technique for correcting acquired hallux varus deformity caused by burn contractures. The pivotless distraction method, combined with skin grafting and Z-plasty, offers a successful single-stage treatment option.

Area of Science:

Orthopedic surgery
Burn reconstruction
Pediatric deformity correction

Background:

Acquired hallux varus deformity from postburn contracture is rare, causing significant functional and cosmetic issues.
Previous treatments like soft-tissue procedures and tendon transfers often require multiple surgeries with suboptimal outcomes.

Observation:

A 6-year-old patient with a neglected hallux varus deformity secondary to burn contracture was treated.
The deformity presented with cosmetic disfigurement, pain, and difficulty wearing shoes.

Findings:

A single-stage procedure involving contracture release with a pivotless distraction technique (biplanar distractor), skin grafting, and Z-plasty was performed.
Gradual differential distraction with radiographic monitoring achieved correction with good functional outcomes.

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The patient regained pain-free flexion of 45° and extension of 40°, enabling shoe wear within 4 weeks.

Implications:

This technique offers a viable alternative for correcting rigid hallux varus deformities, potentially avoiding multiple operations.
Preservation of joint function is a key advantage of this approach.
The method demonstrates successful management of a complex pediatric burn-related deformity.