Surgical options for hallux rigidus: state of the art and review of the literature
- 7 August 2019
- journal article
- review article
- Published by Springer Science and Business Media LLC in European Journal of Orthopaedic Surgery & Traumatology
- Vol. 30 (1), 57-65
- https://doi.org/10.1007/s00590-019-02528-x
Abstract
Hallux rigidus is a painful condition of the great toe characterized by restriction of the metatarsophalangeal range of motion and progressive osteophyte formation. Many etiologies have been postulated including excessive length of the first ray, trauma, abnormally elevated first metatarsal and a positive family history. However, most cases are likely idiopathic. Plain radiographs are used to grade the severity of hallux rigidus. The more comprehensive grading is represented by Coughlin and Shurnas' system that introduced a four-grade classification. When nonoperative treatment fails to provide relief, surgery should be performed. The goal of surgery is to relieve pain, maintain stability of the first metatarsophalangeal joint and improve function and quality of life. Operative treatments can be divided into joint sparing (e.g., cheilectomy with or without associated osteotomies) versus joint sacrificing (e.g., arthroplasty or arthrodesis). There are a variety of osteotomies available for treatment of hallux rigidus (phalanx and/or metatarsal osteotomies). Newer techniques of interpositional arthroplasty as well as new hemi-arthroplasty designs, including synthetic cartilage implants, offer promising options for preservation of motion. The choice of procedure is based on the condition of the joint, patient's goals and expectations of the surgical outcome, and patient's motivation. This article discusses various procedures along with clinical outcomes and complications. The advantages and disadvantages of each procedure are discussed.Keywords
This publication has 53 references indexed in Scilit:
- The long-term patient focused outcomes of the Keller's arthroplasty for the treatment of hallux rigidusThe Foot, 2012
- Joint-Preserving Procedure for Moderate Hallux RigidusFoot and Ankle Clinics, 2012
- Multiplanar Phalangeal and Metatarsal Osteotomies for Hallux RigidusClinics in Podiatric Medicine and Surgery, 2011
- Etiology, Pathophysiology, and Staging of Hallux RigidusClinics in Podiatric Medicine and Surgery, 2011
- The Valenti technique in the treatment of hallux rigidusOrthopaedics & Traumatology: Surgery & Research, 2009
- Surgical Management of Hallux Rigidus: Cheilectomy and Osteotomy (Phalanx and Metatarsal)Foot and Ankle Clinics, 2009
- Phalangeal osteotomy versus first metatarsal decompression osteotomy for the surgical treatment of hallux rigidus: A prospective study of age-matched and condition-matched patientsThe Journal of Foot and Ankle Surgery, 2005
- Hallux rigidus deformity: radiologic assessment.American Journal of Roentgenology, 1991
- Hallux valgus deformity: preoperative radiologic assessment.American Journal of Roentgenology, 1990
- VentrotomyBMJ, 1887