THE PREHALLUX IN RELATION TO FLATFOOT

In 1929 I1described an operation for the correction of certain cases of intractable flatfoot by the removal of the prehallux or accessory scaphoid and transplantation of the posterior tibial tendon. In that article the literature was reviewed and a bibliography given. It was stated that the prehallux is a common and frequently unrecognized anomaly which, by changes in leverage, interferes with the normal mechanics of the action of the posterior tibial muscle and thus produces weakness of the longitudinal arch and flatfoot of a type highly resistant to the usual conservative methods of treatment. It was also stated that in the presence of the prehallux, whether as a separate bone or as a prolongation inward of the scaphoid, there is an abnormal insertion of the tibialis posticus tendon. Instead of passing under the inner end of the scaphoid to insert in the lower surface of the two internal