Proximal Phalanx Osteotomy for the Surgical Treatment of Hallux Rigidus

This study reviewed 17 patients (24 great toes) treated by a single surgeon for hallux rigidus with a dorsal-closing wedge osteotomy of the proximal phalanx in conjunction with a moderate cheilectomy. The average age of patients was 47 years (range, 20–69 years). The minimum follow-up was 1 year (ra...

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Bibliographic Details
Published in:Foot & ankle international 1999-01, Vol.20 (1), p.3-12
Main Authors: Thomas, Patrick J., Smith, Ronald W.
Format: Article
Language:English
Subjects:
Adult
Aged
Combined Modality Therapy
Female
Follow-Up Studies
Foot Bones - surgery
Hallux - physiopathology
Hallux - surgery
Humans
Male
Metatarsophalangeal Joint - diagnostic imaging
Metatarsophalangeal Joint - physiopathology
Metatarsophalangeal Joint - surgery
Middle Aged
Movement
Osteoarthritis - diagnostic imaging
Osteoarthritis - pathology
Osteoarthritis - physiopathology
Osteoarthritis - surgery
Osteotomy - adverse effects
Osteotomy - methods
Patient Satisfaction
Radiography
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Summary:This study reviewed 17 patients (24 great toes) treated by a single surgeon for hallux rigidus with a dorsal-closing wedge osteotomy of the proximal phalanx in conjunction with a moderate cheilectomy. The average age of patients was 47 years (range, 20–69 years). The minimum follow-up was 1 year (range, 1–16 years; median follow-up, 30 months), and all but five patients were studied for 2 years or more. Ninety-six percent of patients affirmed their decision to have surgery if they had to make the choice again. Subjectively, all patients improved. Preoperatively, 67% of the cases had severe pain by American Orthopaedic Foot and Ankle Society criteria. Postoperatively, 58% had no pain and 42% had mild pain. There was 100% union rate of the osteotomy. Seven of 10 women and 1 of 7 men still had some restrictions on footwear options postoperatively. Recovery time from the patients' perspective was 2 to 12 months (average, 5.6 months). Based on the results of this study, the authors suggest that the addition of a dorsal-closing wedge osteotomy of the proximal phalanx increases patient satisfaction, compared with their review of patients treated by cheilectomy alone. The procedure provides good pain relief and has few complications.
ISSN:1071-1007
1944-7876
DOI:10.1177/107110079902000102