What is the most common complication following pre-axial polydactyly repair?

What is the most common complication following pre-axial polydactyly repair?

• A. Metatarsus Adductus
• B. Hallux Varus
• C. Hallux Valgus
• D. Splaying of the First Ray

Answer: (B)

The main idea is that soft tissue balance around the first ray is disrupted after repairing pre-axial polydactyly, making hallux varus the most common complication. Hallux varus is an inward deviation of the big toe at the first metatarsophalangeal joint. After removing the extra medial toe and reconstructing the first ray, the forces on the toe can become imbalanced—often with tightening or over-tightening of medial soft tissues and insufficient balancing of the lateral side. This imbalance pulls the toe medially as it heals, leading to a varus position that can be painful and function-limiting. Metatarsus adductus and hallux valgus describe different patterns of forefoot alignment or deformity that are less typically precipitated specifically by pre-axial polydactyly correction. Splaying of the first ray indicates instability of the first ray, which can occur but is not as commonly the immediate postoperative complication as hallux varus.

The main idea is that soft tissue balance around the first ray is disrupted after repairing pre-axial polydactyly, making hallux varus the most common complication. Hallux varus is an inward deviation of the big toe at the first metatarsophalangeal joint. After removing the extra medial toe and reconstructing the first ray, the forces on the toe can become imbalanced—often with tightening or over-tightening of medial soft tissues and insufficient balancing of the lateral side. This imbalance pulls the toe medially as it heals, leading to a varus position that can be painful and function-limiting.

Metatarsus adductus and hallux valgus describe different patterns of forefoot alignment or deformity that are less typically precipitated specifically by pre-axial polydactyly correction. Splaying of the first ray indicates instability of the first ray, which can occur but is not as commonly the immediate postoperative complication as hallux varus.