First Web Space Soft Tissue Release: A New Sequential Approach

Soft tissue release in the first web space plays an important role in addressing the muscle imbalance and correction of hallux valgus deformity. This procedure underwent significant modifications over the years since its original description. Therefore, the term “distal soft tissue release” replaced the eponym McBride or modified McBride procedure. It is more appropriately termed “first web space release.” The current approach is through a dorsal incision in the web space. The structures released include the insertion of adductor tendon, the deep transverse metatarsal ligament, the lateral capsule, and the lateral sesamoid metatarsal ligament. This article describes a new approach to the soft tissue release. The incision is in the web fold of the first web space, allowing for better visualization, and there is a sequential assessment and release of the contracted structures.