Criteria for fibular sesamoidectomy in hallux abducto valgus correction.

Fibular sesamoidectomy is necessary in certain instances to achieve permanent correction of hallux abducto valgus deformities. The decision to remove the fibular sesamoid is usually based on the position of the tibial sesamoid (which is determined by clinical and radiographic examination). If the fibular sesamoid is in positions 4 to 7, it is difficult, if not impossible, to maintain the correction of the hallux abducto valgus; if the position is 1 through 3, the sesamoids can be moved medially and maintained by the crista which is still intact.