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Hallux rigidus.
Michael J Coughlin1, Paul S Shurnas
1St. Alphonsus Regional Medical Center, Boise, ID, USA. footmd@aol.com
The Journal of Bone and Joint Surgery. American Volume
|October 7, 2004
Summary
Surgical treatment for hallux rigidus, including cheilectomy and arthrodesis, shows long-term success. Cheilectomy is effective for early-stage hallux rigidus, while arthrodesis is recommended for advanced cases.
Area of Science:
- Orthopaedic Surgery
- Foot and Ankle Surgery
- Degenerative Joint Disease
Background:
- Hallux rigidus is a common condition with limited long-term surgical outcome data.
- Evaluating surgical interventions for hallux rigidus is crucial for patient management.
- Assessing a novel clinical grading system for hallux rigidus is important.
Purpose of the Study:
- To evaluate the long-term outcomes of surgical treatment for hallux rigidus.
- To assess the efficacy of cheilectomy and metatarsophalangeal joint arthrodesis.
- To validate a new clinical grading system for hallux rigidus.
Main Methods:
- A retrospective review of patients treated between 1981 and 1999.
- Utilized a new five-grade clinical and radiographic grading system for hallux rigidus.
- Assessed outcomes using pre- and post-operative pain scores, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and range of motion.
Main Results:
- Significant improvements in pain, dorsiflexion, and total motion were observed post-surgery.
- Ninety-seven percent of patients reported good or excellent subjective results.
- Cheilectomy demonstrated high success rates (92%) for pain relief and function in specific grades of hallux rigidus.
Conclusions:
- Cheilectomy is a predictable and successful treatment for Grade-1, Grade-2, and selected Grade-3 hallux rigidus.
- Arthrodesis is the recommended surgical approach for Grade-4 hallux rigidus or severe Grade-3 cases.
- The study validates the long-term efficacy of surgical interventions for hallux rigidus.