title: Severe Hallux Valgus With Coalition of the Hallux Sesamoids Treated With Modified Lapidus Procedure: A Case Report.
abstract: Coalition of the hallux sesamoids is an extremely rare condition. To our knowledge, only 1 case report has been published. We report a case of severe hallux valgus deformities with coalitions of the hallux sesamoids. The coalitions themselves were asymptomatic; however, this severe hallux valgus deformity needed to be surgically treated. The hallux sesamoids in both feet appeared to be fused and heart shaped on anteroposterior radiographs and dumbbell shaped on axial radiographs. It is known that postoperative incomplete reduction of the medial sesamoids can be a risk factor for the recurrence of hallux valgus. The computed tomography scan demonstrated a groove in the bottom of the center of the heart-shaped sesamoid. The flexor hallucis longus tendon was located in the groove. Therefore, a modified Lapidus procedure was performed considering the medial half of the heart-shaped sesamoid as the medial sesamoid. Although delayed union occurred, successful correction of the deformity was achieved.
  
  
  METHODS
  Level IV.
authors.affiliation: Department of Orthopaedic Surgery, Chiba Aiyukai Memorial Hospital, Nagareyama City, Chiba, Japan (TK).|Department of Orthopaedic Surgery, Mito Red Cross Hospital, Mito City, Ibaraki, Japan (SS).
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kurashige
authors.affiliation: Department of Orthopaedic Surgery, Chiba Aiyukai Memorial Hospital, Nagareyama City, Chiba, Japan (TK).|Department of Orthopaedic Surgery, Mito Red Cross Hospital, Mito City, Ibaraki, Japan (SS).
authors.forename: Seiichi
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D001863:Bone Screws; D005260:Female; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D020127:Recovery of Function; D018570:Risk Assessment; D012716:Sesamoid Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Lapidus procedure; coalition; flexor hallucis longus; hallux valgus; sesamoids