Hallux varus and clawing are occasionally seen after a McBride procedure, due to the severance of the flexor hallucis brevis, when the lateral sesamoid is removed. The present study includes six patients, (involving ten feet), who developed
hallux varus and great toe clawing after McBride procedures were performed by various orthopedic surgeons. Treatment utilized partial proximal phalangeal resection, with and without
silicone single-stem implants, extensor hallucis longus
tendon transfer to the great toe metatarsal, and interphalangeal joint
arthrodesis, or
tenodesis of the great toe to correct clawing. One patient eventually required a great toe metatarsophalangeal joint fusion. This reconstructive surgery is generally effective by correcting capsular malalignment, the "bowstringing" tendency of the extensor hallucis longus, and great toe clawing that develops simultaneously with
hallux varus. Lateral sesamoidectomy is risky, and believed unnecessary as adductor hallucis
tenotomy is effective in relieving
hallux valgus. Although, it can occur with excessive excision of the medial emminence and distal advancement of the abductor hallucis. The author is unaware of
hallux varus developing after adductor hallucis
tenotomies.