CME OnDemand: Novel Imaging and MIS Techniques in Foot and Ankle Care (2026)-MIS in Metatarsus Adductus

Video Transcription

Video Summary

The talk reviews an algorithm for treating hallux valgus when metatarsus adductus is present. Treatment planning should consider: severity of metatarsus adductus and hallux valgus (not always correlated), first-ray hypermobility, TMT joint arthritis, and associated lesser-toe deformities. If metatarsus adductus and/or TMT arthritis is significant, TMT arthrodesis (often 1st–3rd) is favored. With first-ray hypermobility, a Lapidus procedure is recommended. Moderate metatarsus adductus often leads to metatarsal osteotomies; severe cases, especially in older patients, may require arthrodesis due to higher recurrence (up to ~30%). Osteotomies can be open (proximal) or minimally invasive (often distal oblique/DMMO; sometimes proximal without fixation). MIS can effectively improve angles and patient outcomes, though swelling may persist 6–9 months when multiple lesser-toe procedures are done. Studies suggest metatarsus adductus is common and, when properly addressed, outcomes can be similar to isolated hallux valgus.

Asset Subtitle

In this lesson, Dr. Lorena Bejarano Pineda presents part two of metatarsus adductus, focusing on MIS treatment. She reviews an algorithm for treating hallux valgus when metatarsus adductus is present.

Keywords

hallux valgus

metatarsus adductus

tarsometatarsal (TMT) arthrodesis

Lapidus procedure

minimally invasive metatarsal osteotomy (DMMO/MIS)