Surgical options for hallux rigidus

none1noHallux rigidus (HR) is a limitation of dorsiflexion of the first metatarsophalangeal joint associated with pain, and its treatment remains a debated topic in orthopaedic surgery. The aim of this video is to present etiology, functional consequences, clinical findings and guidelines of treatment of HR based on the review of our series of 111 consecutive feet. 86 patients were treated between 1992 and 2002. Labelling factors of each HR were considered for classification. In 7 cases without arthritis, surgical treatment consisted in plantar release. In 18 cases with a grade 1 HR treatment consisted of distal decompressive osteotomies. In 33 cases with a grade 2 HR treatment consisted of cheilectomy. In 53 cases with a grade 3 HR treatment consisted of arthrodesis or resection arthroplasty using bioreabsorbable implant. Immediate weight bearing was allowed with gauze bandage and talus shoes for 4 weeks. All patients were clinically (AOFAS score) and radiographically checked at an average follow up of 4 years. The clinical pre-op score was 42+14 and at follow up was 81+9. The pre-op mean metatarsophalangeal ROM was 27+17, while at follow up was 75+8 (p<0.001). A series of cases of each group are presented and discussed.scientific video presented at 71th Annual Meeting of AAOS, San Francisco 2004noneC. FaldiniC. Faldin