Hallux varus is a condition in which the big toe begins to deviate away from the midline of the foot (toe moves inwards, opposite to a bunion). Hallux varus most commonly develops after a failure of bunion surgery. There are however other conditions which may lead to hallux varus including trauma, removal of a sesamoid bone from the big toe joint and some forms of arthritis.
As the big toe deviates, it begins to get stiff. This stiffness can occur at one or both of the joints of the big toe.
Treatment is far easier when the big toe remains flexible. As the toe joints stiffen, then the ability to correct the deformity and keep the big toe flexible is quite limited, and a fusion of the toe needs to be performed.
The treatment of hallux varus depends upon how bothersome the condition is. If the deformity is mild and the toe remains flexible no treatment is required at all. If the toe begins to deviate considerably and is becoming stiff then this will be quite uncomfortable with shoe wear, and surgery is usually required to correct the toe.
Correction depends on the flexibility of both joints of the big toe and whether or not arthritis is present. Often, a tendon transfer is performed by shifting tendons around the big toe to straighten it and maintain flexibility. One of the more popular procedures which is used, is to redirect a small tendon of the big toe (the extensor halluces brevis transfer of the Myerson procedure). If there is severe arthritis or stiffness or deformity of the toe, then a tendon transfer cannot be performed and often, a fusion of the joint is required.