Technical tip: Reconstruction of medial collateral ligament in correction of hallux valgus deformity with primary medial collateral ligamentous insufficiency.

In cases of hallux valgus deformity with primary medial collateral ligamentous insufficiency, there will be an abnormal hallux valgus angle with relatively normal intermetatarsal angle and sesamoid positions. Metatarsal osteotomies may not be effective to correct the deformity. Plication of the attenuated medial capsule may not be strong enough to provide long lasting correction of the hallux valgus deformity. We describe a minimally invasive technique of reconstruction of the medial collateral ligament by means of extensor hallucis brevis tendon graft. This can provide a stronger medial constraint to prevent recurrence of hallux valgus deformity.