DIE MORPHOLOGIE DES M. ADDUCTOR HALLUCIS UND DEREN BEDEUTUNG FUR DIE OPERATIVE BEHANDLUNG DES HALLUX VALGUS

The Mc Bride procedure for surgical treatment of the hallux valgus varies according to the different morphological features of the M. adductor hallucis. One hundred specimens of human adult feet - some with a hallux valgus deformity - were preserved in formaldehyde and examined under this aspect. The tendon of the M. adductor hallucis shows two heads - a caput transversum and a caput obliquum - and inserts at the basis as well as at the lateral sesamoid bone of the great toe. Morphological differences in type and place of confluence of both tendon heads give us a classification into 8 different types. In most cases the caput transversum inserted into the caput obliquum from the side and in the middle at the level of the lateral sesamoid bone of the great toe. In most cases, specimens with this muscle type showed a hallux valgus. In surgery of the hallux valgus deformity the tendon of the M. adductor hallucis should be detached from its insertion points in order to reduce the tension on the sesamoid bone and to prevent luxation. The insertion of the caput laterale of the M. flexor hallucis brevis at the lateral sesamoid bone should be left as it is.