METATARSUS PRIMUS VARUS OR HALLUX VALGUS?

This paper presents a new name—metatarsus primus varus—for a well known foot deformity; the name indicates the situation of the primary focus of that deformity at the proximal end of the first metatarsal bone; it notes the constant varus position of that bone and the lateral bone wedging at its proximal joint, and considers this an anatomic variation and not the result of inflammation or of the use of faulty shoes; it further considers that the hallux valgus deformity is acquired, and that it may be the result of the varus of the first metatarsal, although faulty shoes and chronic arthritis may also be causative factors. The writer presents the thesis that any operative procedure that does not include the correction of the deformity at its proximal focus is unscientific and inadequate; and that simple cuneiform osteotomy at the metatarso-cuneiform joint, with the redressement of certain secondary changes, is adequate and permanent. Other accompanying foot deformities are briefly discussed.

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