Continuous passive motion as an alternative treatment for iatrogenic hallux limitus

The use and effect of continuous passive motion (CPM) was evaluated for 10 patients suffering from iatrogenic hallux limitus. All patients had previous hallux valgus corrective surgery. After their initial evaluation, patients were instructed to begin CPM therapy at home for a minimum of 4 hr. a day and were instructed to increase range of motion (ROM) as tolerated. CPM was used for 4 weeks. ROM was measured on day 0, 28, 48, 90. There were significant increases in mean extension (p < 0.025) and mean flexion (p < 0.05). All patients reported a decrease in pain and stiffness of the first metatarsophalangeal joint. Seven of the 10 patients treated with CPM had increases in ROM. Three patients, all of whom had first metatarsal elevatus, required an additional surgical procedure. Patients suffering from iatrogenic hallux limitus with no associated first metatarsal elevatus can utilize CPM as a viable alternative to return to functional ROM.