Hinged External Fixation Distraction for Treatment of First Metatarsophalangeal Joint Arthritis

Abstract Treatment for hallux rigidus varies from joint preservation to joint destructive procedures. The objective of the present study was to report an alternative method of treatment of hallux rigidus using hinged external fixation distraction of the first metatarsophalangeal joint and to present...

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Bibliographic Details
Published in:The Journal of foot and ankle surgery 2012-09, Vol.51 (5), p.604-612
Main Authors: Abraham, Jossie S., DPM, AACFAS, Hassani, Hummira, DPM, Lamm, Bradley M., DPM, FACFAS
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Diseases of the osteoarticular system
External Fixators
Female
hallux limitus
hallux rigidus
Hallux Rigidus - diagnostic imaging
Hallux Rigidus - surgery
Humans
joint distraction
joint preservation
Male
Medical sciences
Middle Aged
Miscellaneous. Osteoarticular involvement in other diseases
Orthopedics
Osteoarthritis
Radiography
Retrospective Studies
surgery
Traction
Young Adult
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Summary:Abstract Treatment for hallux rigidus varies from joint preservation to joint destructive procedures. The objective of the present study was to report an alternative method of treatment of hallux rigidus using hinged external fixation distraction of the first metatarsophalangeal joint and to present our surgical technique. Ten distractions were performed in 9 patients (9 female feet [90%] and 1 male foot [10%]). The mean age at surgery was 41.0 (range 20 to 64) years. All patients had stage II or III hallux rigidus on the Regnauld classification system for hallux rigidus. The patients were evaluated clinically and radiographically before and after the distraction treatment. The mean period of fixation was 16.40 (range 7 to 21) weeks. Six of the patients (60%) with distraction experienced pin tract infections that were treated with oral antibiotics. The reported mean preoperative categorical pain score in 7 patients (7 feet) was 8.2 (range 5 to 10), and the postoperative score was 0.83 (range 0 to 2; p = .001). Of the 6 patients (6 feet) who responded to the remaining portion of the survey, 4 (66.67%) were very satisfied with their results, and 2 (33.33%) were satisfied with their surgical result. None of the patients required additional surgical treatment during the mean 2.2 (range 1.2 to 3.3) years of follow-up. Hinged first metatarsophalangeal joint distraction with external fixation has been shown to be a viable treatment option for joint preservation for stage II and III hallux rigidus in the short term.
ISSN:1067-2516
1542-2224
DOI:10.1053/j.jfas.2012.04.022