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Modified Jones procedure for post-polio claw hallux deformity

A A Faraj1

  • 1Orthopaedic Department, Medical City, Baghdad Teaching Hospital, Iraq.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|November 14, 1997
PubMed
Summary

The modified Jones procedure effectively treated postpolio claw hallux deformity in most patients. Careful evaluation of extensor hallucis longus strength and Achilles tendon length is crucial for optimal surgical outcomes.

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Surgery
  • Pediatric Orthopedics

Background:

  • Postpolio claw hallux deformity significantly impacts foot biomechanics and gait.
  • Surgical intervention is often necessary to correct this debilitating condition.

Purpose of the Study:

  • To evaluate the efficacy of a modified Jones procedure for treating postpolio claw hallux deformity.
  • To assess functional outcomes and identify factors influencing success.

Main Methods:

  • Prospective study of 12 patients with postpolio claw hallux.
  • Modified Jones procedure with Kirschner wire for interphalangeal joint fusion.
  • Pre- and postoperative assessment using Axer's criteria with a mean 32-month follow-up.

Main Results:

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  • Ten patients achieved very good results; two had fair results.
  • Two patients experienced recurrence of deformity due to a loose extensor hallucis longus and tight Achilles tendon, requiring revision surgery.
  • No pseudoarthrosis of the interphalangeal joint was observed.

Conclusions:

  • The modified Jones procedure is a viable treatment for postpolio claw hallux.
  • Preoperative assessment of extensor hallucis longus (Medical Research Council Grade V) and Achilles tendon equinus is essential.
  • Addressing tight Achilles tendons prevents residual foot deformities and recurrence.