A retrospective analysis of joint salvage procedures for grades III and IV hallux rigidus

The purpose of this study was to evaluate the outcome of the use of a decompression osteotomy for the treatment of end-stage hallux rigidus. We conducted a retrospective analysis of 28 feet (23 patients) with grades III and IV hallux rigidus that underwent a first metatarsal head decompression osteotomy with preservation of the articular surfaces of the first metatarsophalangeal joint. We also devised a 9-item questionnaire to explore the patients' perceptions of preoperative and postoperative pain, limitations of activity, influence on shoe wear, and the total range of motion of the first metatarsophalangeal joint. Furthermore, we used a modified version of the AOFAS forefoot scoring system to compare the patients' foot-related health status in relative to the operative repair of hallux rigidus. Comparisons of the pre- and postoperative results revealed statistically significant improvements in pain (P< .001), functional limitation (P< .001), shoe restrictions (P= .0072), total range of motion (P= .0449), and the AOFAS forefoot score (P< .001). Overall patient satisfaction with the results of the surgery was more than 85%, and the patients' chief complaint was alleviated in more than 75% of the participants. The results of this investigation demonstrated that a decompression first metatarsal osteotomy is an acceptable alternative to joint destructive procedures for the treatment of end-stage hallux rigidus.

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