Reconstruction of Secondary Type Congenital Hallux Varus with Modification of the Farmer Technique for Cover of Skin Defect: Report of Three Cases

A R Sulaiman; I Munajat; H M-Yusuf; Nms Nik-Jaffar; N H Zarullail; E F Mohd; N A Johari

doi:10.5704/MOJ.1911.013

Reconstruction of Secondary Type Congenital Hallux Varus with Modification of the Farmer Technique for Cover of Skin Defect: Report of Three Cases

Malays Orthop J. 2019 Nov;13(3):72-76. doi: 10.5704/MOJ.1911.013.

Authors

A R Sulaiman^{1

2}, I Munajat^{1

2}, H M-Yusuf², Nms Nik-Jaffar^{1

2}, N H Zarullail^{1

2}, E F Mohd^{1

2}, N A Johari²

Affiliations

¹ Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
² Department of Orthopaedics and Traumatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.

Abstract

The reconstruction of hallux varus deformity involves the release of contracted medial structure and realignment of the phalange, leaving a significant skin defect which requires cover. Farmer described proximal based rotational skin flap from the first web space to cover the defect. This technique may compromise the circulation to the flap and risk to the lateral digital vessels. We modified his technique to address these issues. We report a successful reconstruction using the Farmer's technique on one patient and a modified technique on three patients. We used the excess skin from the extra digit to cover the medial defect. We found this modified technique of skin cover safe without risk of injuring the neurovascular bundle. There was no recurrence of deformity at last foolow-up. All patients were able to wear normal shoes.

Keywords: congenital; excess skin; extra digit; hallux varus; modified technique.

Publication types

Case Reports