# Iatrogenic Hallux Varus in a Patient with Rheumatoid Arthritis

## TL;DR

This case study describes a rare foot deformity in a rheumatoid arthritis patient after surgery, highlighting the challenges and outcomes of treatment.

## Contribution

The paper presents a unique case of iatrogenic hallux varus in a rheumatoid arthritis patient and evaluates surgical outcomes.

## Key findings

- Surgical treatment reduced pain and restored function in the patient.
- A non-union occurred in the first MTP arthrodesis after 24 months but remained asymptomatic.
- Tailored surgical planning is crucial for RA patients with complex foot deformities.

## Abstract

Background/Objectives: Iatrogenic hallux varus is a rare complication often arising after hallux valgus surgery, characterized by medial deviation of the hallux. This report presents the case of a 58-year-old female with iatrogenic hallux varus complicated by rheumatoid arthritis (RA). The objective is to highlight the challenges and outcomes of surgical treatment in RA patients with complex foot deformities. Methods: The patient presented with severe medial deviation of the hallux and claw positioning of the lesser toes, resulting in pain and functional limitations. Radiological analysis indicated overcorrection of the first intermetatarsal angle and deformity of the lesser toes. Surgical management included arthrodesis of the first metatarsophalangeal (MTP) joint using K-wires and resection arthroplasty of the lesser metatarsals. Results: Postoperative outcomes revealed correct alignment, pain reduction, and restoration of functional capabilities. However, a non-union was observed in the first MTP arthrodesis after 24 months, which remained asymptomatic. Conclusions: This case underscores the importance of careful surgical planning in RA patients to balance joint preservation and deformity correction. Arthrodesis proved effective for stability and pain relief in RA-associated deformities, although long-term follow-up remains critical to address complications. Tailored interventions are necessary to improve the quality of life in RA patients with complex foot deformities.