Congenital Hallux Varus with Polydactyly and Syndactyly-Correction in an Adult - A Case Report.
BACKGROUND
Congenital hallux varus of secondary type is associated with polydactyly, syndactyly or other congenital deformities of the foot. Such congenital deformities can be addressed in childhood with soft tissue reconstructive procedures. In adulthood, treatment of these deformities is challenging because of soft tissue contractures and rigid bony deformities. To our knowledge, this is the first case report demonstrating the management of neglected secondary congenital hallux varus in adults.


METHODS
We present here a case of a 23 years old male patient who presented to us with untreated congenital hallux varus of secondary type. Patient had an extra great toe (polydactyly) with syndactyly. We have treated this patient in two stages. First stage consisted of excision of the extra great toe and gradual correction of medial great toe. In second stage, metatarsophalangeal joint fusion was done. We have follow up of this case for more than 2.5 years.


CONCLUSIONS
Severe neglected congenital deformities presenting in adulthood pose unique problems of soft tissue contractures and permanent bony deformities. Congenital neglected hallux varus with polydactyly and syndactyly is a rare deformity. Its correction was challenging as patient presented to us in adulthood. A staged approach of gradual soft tissue distraction and then metatarsophalangeal joint fusion has resulted in satisfactory aesthetic and functional outcome.
Orthopaedic Department, Noble Hospital, Hadapsar, Pune- 411013, Maharashtra, India.; Orthopaedic Department, Shri Prayagdham Trust Charitable Hospital, UruliKanchan, Pune- 412202, Maharashtra, India.
Sampat Dumbre
SD
Patil
Orthopaedic Department, SmtKashibaiNavale Medical College and General Hospital, S. No 49/1, Westerly Bypass Road, Narhe (Ambegaon), Pune - 411 041, Maharashtra. India.
Hemant
H
Parekh
Orthopaedic Department, Noble Hospital, Hadapsar, Pune- 411013, Maharashtra, India.
Vaishali Dumbre
VD
Patil
Orthopaedic Department, Shri Prayagdham Trust Charitable Hospital, UruliKanchan, Pune- 412202, Maharashtra, India.
Kartikeya
K
Joshi
Polydactyly with syndactyly; distraction with external fixator; metatarsophalangeal joint fusion; neglected hallux varus; secondary congenital hallux varus