The Valenti procedure for hallux limitus: a long-term follow-up and analysis

A retrospective analysis of the long-term efficacy of the Valenti procedure for hallux limitus was performed from 1989 to 1997. A total of 33 patients (36 procedures) were selected, surveyed, and examined. Preoperative and postoperative radiographic evaluations and levels of function and pain were obtained from medical records. Complications and patient satisfaction data were collected and reviewed. The patients were evaluated clinically and radiographically. The average age of the patient at the time of surgery was 50.6 years (range, 35-75 years) with an average follow-up of 4.16 years (range, 1-9 years). The average grade of hallux limitus/rigidus was grade II. Five patients were classified as grade I, 23 as grade II, five as grade III, and none as grade IV, based on the modified Drago/Regnauld grading system. Subjective results were calculated based on the American Orthopedic Foot and Ankle Society clinical rating system. Twenty-two patients were rated as having an excellent result, 11 had good results, two had fair results, and one patient had a poor result. We conclude that the Valenti arthroplasty for symptomatic hallux rigidus/limitus is a good procedure for arthritic and degenerated first metatarsophalangeal joints where implant arthroplasty, osteotomy, or arthrodesis are not viable options. Advantages include increased range of motion, decreased postoperative pain, technical ease of performance, maintenance of intrinsic musculature, and rapid return to closed footgear.