The modified McBride bunionectomy utilizing the adductor tendon transfer

A modification of the McBride bunionectomy utilizing the adductor tendon transfer is described. It includes transposition of the adductor hallucis tendon into the medial capsular flap via a pulley suture, and derotation of the sesamoidal apparatus. This is accomplished by torque placed on the medial capsular flap. It is transferred to the medial sesamoid through the tibial sesamoid ligament and then to the fibular sesamoid by the intersesamoidal ligament. The contracted fibular sesamoid ligament is sacrificed. The procedure helps to maintain reduction of an increased intermetatarsal angle, with hypermobile first ray. Another advantage is the ability to perform a concomitant metatarsal neck osteotomy, when necessary. This was not possible in the original McBride bunionectomy in which the adductor tendon was transposed to the head of the first metatarsal through a drill hole. Short-term results have been encouraging.