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Paul S. Shurnas - One of the best experts on this subject based on the ideXlab platform.
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Hallux Rigidus: demographics, etiology, and radiographic assessment.
Foot & ankle international, 2020Co-Authors: Michael J Coughlin, Paul S. ShurnasAbstract:The purpose of the study was to evaluate the demographics, etiology, and radiographic findings associated with Hallux Rigidus in patients treated surgically over a 19-year period in a single surgeon's practice. Patients treated for Hallux Rigidus by cheilectomy and metatarsophalangeal joint fusion were identified from 1981 to 1999. Patients who had diabetes, inflammatory arthritis, infectious arthritis, crystalline arthritis, multiple forefoot deformities, neuromuscular disorders, or had died were excluded. A chart review and evaluation of preoperative radiographs were completed on all eligible patients. All identified patients were invited for a follow-up examination that included standard and stress radiographs, range-of-motion testing, Harris mat study, gait analysis, first ray mobility measurement, and standardized questionnaire assessment. One hundred ten of 114 (96.5%) patients with a diagnosis of Hallux Rigidus returned for the final evaluation. Eighty cheilectomy patients (93 feet) and 30 arthrodesis patients (34 feet) were evaluated. The mean age at onset in the current study was 43 years (13-70 years) and only six patients developed symptoms at an age of less than 20 years. Hallux Rigidus was graded based on a five-grade clinical-radiographic system. The mean follow-up was 8.9 years. Ninety-five percent of patients with a positive family history had bilateral disease at the final follow-up. At the initial examination in the current study, 81% of patients had radiographic and clinical evidence of unilateral disease, but at the final follow-up 79% of patients had radiographic and clinical evidence of bilateral disease. Eleven percent of patients in the present series had pes planus based on either a positive Harris mat study and/or heel valgus. There was no evidence of an Achilles or gastrocnemius tendon contracture. Radiographic analysis found that the concurrent presentation of Hallux valgus and Hallux Rigidus was not common. Ninety-three of 127 feet (73%) had a chevron or flat metatarsophalangeal joint. Thirty-five feet were noted to have mild or moderate metatarsus adductus. A long first metatarsal was no more common in patients with Hallux Rigidus than in the general population. The mean first ray elevatus was 5.5 mm and was well within acceptable limits of normal. The mean first ray mobility was 5 mm in arthrodesis patients and 5.8 mm in cheilectomy patients. Hallux Rigidus was not associated with elevatus, first ray hypermobility, a long first metatarsal, Achilles or gastrocnemius tendon tightness, abnormal foot posture, symptomatic Hallux valgus, adolescent onset, shoewear, or occupation. Hallux Rigidus was associated with Hallux valgus interphalangeus, bilateral involvement in those with a familial history, unilateral involvement in those with a history of trauma, and female gender. Metatarsus adductus was more common in patients with Hallux Rigidus than in the general population but a clear correlation was not found. Additionally, a flat or chevron-shaped metatarsophalangeal joint was more common in Hallux Rigidus patients.
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Hallux Rigidus etiology biomechanics and nonoperative treatment
Foot and Ankle Clinics of North America, 2009Co-Authors: Paul S. ShurnasAbstract:Hallux Rigidus is a degenerative osteoarthritic process characterized by progressive loss of metatarsophalangeal joint range of motion and notable dorsal or periarticular osteophyte formation. Documented factors associated with Hallux Rigidus are a flat or chevron-shaped joint, Hallux valgus interphalangeus, metatarsus adductus, bilaterality in persons with a positive family history, trauma history in unilateral cases, and female gender. Elevation of the first ray noted radiographically is thought to be a sign of worsening metatarsophalangeal joint function. Nonoperative care is aimed at improving comfort of the toe and foot with roomy shoes, selective joint injections, taping, and selective use of orthotics.
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Hallux Rigidus: Etiology, Biomechanics, and Nonoperative Treatment
Foot and Ankle Clinics, 2009Co-Authors: Paul S. ShurnasAbstract:Hallux Rigidus is a degenerative osteoarthritic process characterized by progressive loss of metatarsophalangeal joint range of motion and notable dorsal or periarticular osteophyte formation. Documented factors associated with Hallux Rigidus are a flat or chevron-shaped joint, Hallux valgus interphalangeus, metatarsus adductus, bilaterality in persons with a positive family history, trauma history in unilateral cases, and female gender. Elevation of the first ray noted radiographically is thought to be a sign of worsening metatarsophalangeal joint function. Nonoperative care is aimed at improving comfort of the toe and foot with roomy shoes, selective joint injections, taping, and selective use of orthotics. © 2009 Elsevier Inc. All rights reserved.
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Hallux Rigidus surgical techniques cheilectomy and arthrodesis
Journal of Bone and Joint Surgery American Volume, 2004Co-Authors: Michael J Coughlin, Paul S. ShurnasAbstract:BACKGROUND: There have been few long-term studies documenting the outcome of surgical treatment of Hallux Rigidus. The purposes of this report were to evaluate the long-term results of the operative treatment of Hallux Rigidus over a nineteen-year period in one surgeon's practice and to assess a clinical grading system for use in the treatment of Hallux Rigidus. METHODS: All patients in whom degenerative Hallux Rigidus had been treated with cheilectomy or metatarsophalangeal joint arthrodesis between 1981 and 1999 and who were alive at the time of this review were identified and invited to return for a follow-up evaluation. At this follow-up evaluation, the Hallux Rigidus was graded with a new five-grade clinical and radiographic system. Outcomes were assessed by comparison of preoperative and postoperative pain and AOFAS (American Orthopaedic Foot and Ankle Society) scores and ranges of motion. These outcomes were then correlated with the preoperative grade and the radiographic appearance at the time of follow-up. RESULTS: One hundred and ten of 114 patients with a diagnosis of Hallux Rigidus returned for the final evaluation. Eighty patients (ninety-three feet) had undergone a cheilectomy, and thirty patients (thirty-four feet) had had an arthrodesis. The mean duration of follow-up was 9.6 years after the cheilectomies and 6.7 years after the arthrodeses. There was significant improvement in dorsiflexion and total motion following the cheilectomies (p = 0.0001) and significant improvement in postoperative pain and AOFAS scores in both treatment groups (p = 0.0001). A good or excellent outcome based on patient self-assessment, the pain score, and the AOFAS score did not correlate with the radiographic appearance of the joint at the time of final follow-up. Dorsiflexion stress radiographs demonstrated correction of the elevation of the first ray to nearly zero. There was no association between Hallux Rigidus and hypermobility of the first ray, functional Hallux limitus, or metatarsus primus elevatus. CONCLUSIONS: Ninety-seven percent (107) of the 110 patients had a good or excellent subjective result, and 92% (eighty-six) of the ninety-three cheilectomy procedures were successful in terms of pain relief and function. Cheilectomy was used with predictable success to treat Grade-1 and 2 and selected Grade-3 cases. Patients with Grade-4 Hallux Rigidus or Grade-3 Hallux Rigidus with <50% of the metatarsal head cartilage remaining at the time of surgery should be treated with arthrodesis.
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Hallux Rigidus: Surgical techniques (cheilectomy and arthrodesis)
Journal of Bone and Joint Surgery American Volume, 2004Co-Authors: Michael J Coughlin, Paul S. ShurnasAbstract:BACKGROUND: There have been few long-term studies documenting the outcome of surgical treatment of Hallux Rigidus. The purposes of this report were to evaluate the long-term results of the operative treatment of Hallux Rigidus over a nineteen-year period in one surgeon's practice and to assess a clinical grading system for use in the treatment of Hallux Rigidus. METHODS: All patients in whom degenerative Hallux Rigidus had been treated with cheilectomy or metatarsophalangeal joint arthrodesis between 1981 and 1999 and who were alive at the time of this review were identified and invited to return for a follow-up evaluation. At this follow-up evaluation, the Hallux Rigidus was graded with a new five-grade clinical and radiographic system. Outcomes were assessed by comparison of preoperative and postoperative pain and AOFAS (American Orthopaedic Foot and Ankle Society) scores and ranges of motion. These outcomes were then correlated with the preoperative grade and the radiographic appearance at the time of follow-up. RESULTS: One hundred and ten of 114 patients with a diagnosis of Hallux Rigidus returned for the final evaluation. Eighty patients (ninety-three feet) had undergone a cheilectomy, and thirty patients (thirty-four feet) had had an arthrodesis. The mean duration of follow-up was 9.6 years after the cheilectomies and 6.7 years after the arthrodeses. There was significant improvement in dorsiflexion and total motion following the cheilectomies (p = 0.0001) and significant improvement in postoperative pain and AOFAS scores in both treatment groups (p = 0.0001). A good or excellent outcome based on patient self-assessment, the pain score, and the AOFAS score did not correlate with the radiographic appearance of the joint at the time of final follow-up. Dorsiflexion stress radiographs demonstrated correction of the elevation of the first ray to nearly zero. There was no association between Hallux Rigidus and hypermobility of the first ray, functional Hallux limitus, or metatarsus primus elevatus. CONCLUSIONS: Ninety-seven percent (107) of the 110 patients had a good or excellent subjective result, and 92% (eighty-six) of the ninety-three cheilectomy procedures were successful in terms of pain relief and function. Cheilectomy was used with predictable success to treat Grade-1 and 2 and selected Grade-3 cases. Patients with Grade-4 Hallux Rigidus or Grade-3 Hallux Rigidus with
Michael J Coughlin - One of the best experts on this subject based on the ideXlab platform.
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Hallux Rigidus: demographics, etiology, and radiographic assessment.
Foot & ankle international, 2020Co-Authors: Michael J Coughlin, Paul S. ShurnasAbstract:The purpose of the study was to evaluate the demographics, etiology, and radiographic findings associated with Hallux Rigidus in patients treated surgically over a 19-year period in a single surgeon's practice. Patients treated for Hallux Rigidus by cheilectomy and metatarsophalangeal joint fusion were identified from 1981 to 1999. Patients who had diabetes, inflammatory arthritis, infectious arthritis, crystalline arthritis, multiple forefoot deformities, neuromuscular disorders, or had died were excluded. A chart review and evaluation of preoperative radiographs were completed on all eligible patients. All identified patients were invited for a follow-up examination that included standard and stress radiographs, range-of-motion testing, Harris mat study, gait analysis, first ray mobility measurement, and standardized questionnaire assessment. One hundred ten of 114 (96.5%) patients with a diagnosis of Hallux Rigidus returned for the final evaluation. Eighty cheilectomy patients (93 feet) and 30 arthrodesis patients (34 feet) were evaluated. The mean age at onset in the current study was 43 years (13-70 years) and only six patients developed symptoms at an age of less than 20 years. Hallux Rigidus was graded based on a five-grade clinical-radiographic system. The mean follow-up was 8.9 years. Ninety-five percent of patients with a positive family history had bilateral disease at the final follow-up. At the initial examination in the current study, 81% of patients had radiographic and clinical evidence of unilateral disease, but at the final follow-up 79% of patients had radiographic and clinical evidence of bilateral disease. Eleven percent of patients in the present series had pes planus based on either a positive Harris mat study and/or heel valgus. There was no evidence of an Achilles or gastrocnemius tendon contracture. Radiographic analysis found that the concurrent presentation of Hallux valgus and Hallux Rigidus was not common. Ninety-three of 127 feet (73%) had a chevron or flat metatarsophalangeal joint. Thirty-five feet were noted to have mild or moderate metatarsus adductus. A long first metatarsal was no more common in patients with Hallux Rigidus than in the general population. The mean first ray elevatus was 5.5 mm and was well within acceptable limits of normal. The mean first ray mobility was 5 mm in arthrodesis patients and 5.8 mm in cheilectomy patients. Hallux Rigidus was not associated with elevatus, first ray hypermobility, a long first metatarsal, Achilles or gastrocnemius tendon tightness, abnormal foot posture, symptomatic Hallux valgus, adolescent onset, shoewear, or occupation. Hallux Rigidus was associated with Hallux valgus interphalangeus, bilateral involvement in those with a familial history, unilateral involvement in those with a history of trauma, and female gender. Metatarsus adductus was more common in patients with Hallux Rigidus than in the general population but a clear correlation was not found. Additionally, a flat or chevron-shaped metatarsophalangeal joint was more common in Hallux Rigidus patients.
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Hallux Rigidus surgical techniques cheilectomy and arthrodesis
Journal of Bone and Joint Surgery American Volume, 2004Co-Authors: Michael J Coughlin, Paul S. ShurnasAbstract:BACKGROUND: There have been few long-term studies documenting the outcome of surgical treatment of Hallux Rigidus. The purposes of this report were to evaluate the long-term results of the operative treatment of Hallux Rigidus over a nineteen-year period in one surgeon's practice and to assess a clinical grading system for use in the treatment of Hallux Rigidus. METHODS: All patients in whom degenerative Hallux Rigidus had been treated with cheilectomy or metatarsophalangeal joint arthrodesis between 1981 and 1999 and who were alive at the time of this review were identified and invited to return for a follow-up evaluation. At this follow-up evaluation, the Hallux Rigidus was graded with a new five-grade clinical and radiographic system. Outcomes were assessed by comparison of preoperative and postoperative pain and AOFAS (American Orthopaedic Foot and Ankle Society) scores and ranges of motion. These outcomes were then correlated with the preoperative grade and the radiographic appearance at the time of follow-up. RESULTS: One hundred and ten of 114 patients with a diagnosis of Hallux Rigidus returned for the final evaluation. Eighty patients (ninety-three feet) had undergone a cheilectomy, and thirty patients (thirty-four feet) had had an arthrodesis. The mean duration of follow-up was 9.6 years after the cheilectomies and 6.7 years after the arthrodeses. There was significant improvement in dorsiflexion and total motion following the cheilectomies (p = 0.0001) and significant improvement in postoperative pain and AOFAS scores in both treatment groups (p = 0.0001). A good or excellent outcome based on patient self-assessment, the pain score, and the AOFAS score did not correlate with the radiographic appearance of the joint at the time of final follow-up. Dorsiflexion stress radiographs demonstrated correction of the elevation of the first ray to nearly zero. There was no association between Hallux Rigidus and hypermobility of the first ray, functional Hallux limitus, or metatarsus primus elevatus. CONCLUSIONS: Ninety-seven percent (107) of the 110 patients had a good or excellent subjective result, and 92% (eighty-six) of the ninety-three cheilectomy procedures were successful in terms of pain relief and function. Cheilectomy was used with predictable success to treat Grade-1 and 2 and selected Grade-3 cases. Patients with Grade-4 Hallux Rigidus or Grade-3 Hallux Rigidus with <50% of the metatarsal head cartilage remaining at the time of surgery should be treated with arthrodesis.
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Hallux Rigidus: Surgical techniques (cheilectomy and arthrodesis)
Journal of Bone and Joint Surgery American Volume, 2004Co-Authors: Michael J Coughlin, Paul S. ShurnasAbstract:BACKGROUND: There have been few long-term studies documenting the outcome of surgical treatment of Hallux Rigidus. The purposes of this report were to evaluate the long-term results of the operative treatment of Hallux Rigidus over a nineteen-year period in one surgeon's practice and to assess a clinical grading system for use in the treatment of Hallux Rigidus. METHODS: All patients in whom degenerative Hallux Rigidus had been treated with cheilectomy or metatarsophalangeal joint arthrodesis between 1981 and 1999 and who were alive at the time of this review were identified and invited to return for a follow-up evaluation. At this follow-up evaluation, the Hallux Rigidus was graded with a new five-grade clinical and radiographic system. Outcomes were assessed by comparison of preoperative and postoperative pain and AOFAS (American Orthopaedic Foot and Ankle Society) scores and ranges of motion. These outcomes were then correlated with the preoperative grade and the radiographic appearance at the time of follow-up. RESULTS: One hundred and ten of 114 patients with a diagnosis of Hallux Rigidus returned for the final evaluation. Eighty patients (ninety-three feet) had undergone a cheilectomy, and thirty patients (thirty-four feet) had had an arthrodesis. The mean duration of follow-up was 9.6 years after the cheilectomies and 6.7 years after the arthrodeses. There was significant improvement in dorsiflexion and total motion following the cheilectomies (p = 0.0001) and significant improvement in postoperative pain and AOFAS scores in both treatment groups (p = 0.0001). A good or excellent outcome based on patient self-assessment, the pain score, and the AOFAS score did not correlate with the radiographic appearance of the joint at the time of final follow-up. Dorsiflexion stress radiographs demonstrated correction of the elevation of the first ray to nearly zero. There was no association between Hallux Rigidus and hypermobility of the first ray, functional Hallux limitus, or metatarsus primus elevatus. CONCLUSIONS: Ninety-seven percent (107) of the 110 patients had a good or excellent subjective result, and 92% (eighty-six) of the ninety-three cheilectomy procedures were successful in terms of pain relief and function. Cheilectomy was used with predictable success to treat Grade-1 and 2 and selected Grade-3 cases. Patients with Grade-4 Hallux Rigidus or Grade-3 Hallux Rigidus with
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Hallux Rigidus grading and long term results of operative treatment
Journal of Bone and Joint Surgery American Volume, 2003Co-Authors: Michael J Coughlin, Paul S. ShurnasAbstract:Background:There have been few long-term studies documenting the outcome of surgical treatment of Hallux Rigidus. The purposes of this report were to evaluate the long-term results of the operative treatment of Hallux Rigidus over a nineteen-year period in one surgeon's practice and to assess a clin
S. Zaffagnini - One of the best experts on this subject based on the ideXlab platform.
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Management of high-grade Hallux Rigidus: a narrative review of the literature
MUSCULOSKELETAL SURGERY, 2020Co-Authors: S. Massimi, S. Caravelli, M. Fuiano, C. Pungetti, M. Mosca, S. ZaffagniniAbstract:Hallux Rigidus is a disease characterized by an osteoarthritic degeneration of the first metatarsophalangeal joint. Aetiology of Hallux Rigidus is not clear in the literature. History of trauma is considered one of the most common causes of unilateral Hallux Rigidus. Also, repetitive microtraumas or inflammatory and metabolic causes such as gout, rheumatoid arthritis and seronegative arthropathy can cause degeneration of the joint. The aim of this literature narrative overview is to summarize and expose the great amount of management concepts and information, including the well-codified main operative procedures to treat of Hallux Rigidus. This may provide current information for med-school students, researchers and physicians. A comprehensive literature search using PubMed database has been performed. The management for Hallux Rigidus can involve a variety of therapeutic interventions, conservative or operative. High-grade Hallux Rigidus represents a complex disease characterized by several clinical and pathological findings, and to achieve optimal results, surgical treatment should be chosen between several surgical techniques depending on the degree of arthritis and other different clinical conditions.
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A comprehensive and narrative review of historical aspects and management of low-grade Hallux Rigidus: conservative and surgical possibilities
MUSCULOSKELETAL SURGERY, 2018Co-Authors: S. Caravelli, S. Massimi, M. Fuiano, C. Pungetti, M. Mosca, A. Russo, G. Catanese, S. ZaffagniniAbstract:Hallux Rigidus, Latin for Stiff Toe, is characterized by an osteoarthritic degeneration of the articular surfaces of the first metatarsophalangeal joint. The aim of this literature narrative overview is to summarize and expose the great amount of management concepts and information, including the well-codified operative procedures and the more up to date knowledge about non-operative and surgical treatment of Hallux Rigidus. This may provide current information for physicians, medschool attendants and researchers. A comprehensive literature search using PubMed database has been performed, up to April 1, 2017. Several different types of treatment are described in the literature for low-grade Hallux Rigidus. The management for Hallux Rigidus can involve a variety of therapeutic interventions, conservative or operative. Hallux Rigidus is a complex disease characterized by several clinical and pathological findings, and to achieve optimal results, surgical treatment for low-grade forms should be chosen between several surgical techniques depending on the degree of arthritis and other different clinical conditions.
Thomas S Roukis - One of the best experts on this subject based on the ideXlab platform.
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outcomes after cheilectomy with phalangeal dorsiflexory osteotomy for Hallux Rigidus a systematic review
Journal of Foot & Ankle Surgery, 2010Co-Authors: Thomas S RoukisAbstract:Abstract Cheilectomy with phalangeal dorsiflexory osteotomy has been proposed for treatment of Hallux Rigidus because of its perceived safety and efficacy and because it does not prevent the ability to perform revision surgery. The author undertook a systematic review to identify material relating to the clinical outcomes after cheilectomy with phalangeal dorsiflexory osteotomy for Hallux Rigidus. Studies were considered only if they involved consecutively enrolled patients undergoing cheilectomy with phalangeal dorsiflexory osteotomy, evaluated patients at mean follow-up ≥ 12 months' duration, included some form of objective and subjective data analysis, and included details of complications requiring surgical intervention. Eleven studies involving a total of 374 procedures were identified that met the inclusion criteria. Pain was relieved or improved in 149/167 (89.2%) procedures, and 139/217 (77%) patients related being satisfied or very satisfied with their outcomes. A total of 18 (4.8%) procedures underwent surgical revision. Six studies involving 177 procedures specified the grade of Hallux Rigidus as follows: grade I, 10.2% (n = 18); grade II, 72.3% (n = 128); and grade III, 17.5% (n = 31). The results of this systematic review make clear the general improvement in objective and subjective data as well as the low incidence of revision surgery required after cheilectomy with phalangeal dorsiflexory osteotomy for Hallux Rigidus. Therefore, cheilectomy with phalangeal dorsiflexory osteotomy should be considered a first-line surgical treatment for Hallux Rigidus. However, there is still a need for methodologically sound prospective cohort studies that focus on the use of this procedure for specific grades of Hallux Rigidus and compare the subjective and objective outcomes as well as the need for surgical revision with other procedures.
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the need for surgical revision after isolated cheilectomy for Hallux Rigidus a systematic review
Journal of Foot & Ankle Surgery, 2010Co-Authors: Thomas S RoukisAbstract:Isolated cheilectomy has been proposed for treatment of Hallux Rigidus due to the perceived safety, efficacy, and ability to revise with repeat cheilectomy, implant or interpositional arthroplasty, or arthrodesis. A systematic review was undertaken to better understand the need for surgical revision after isolated cheilectomy for Hallux Rigidus. Studies were eligible for inclusion only if they involved consecutively enrolled patients undergoing isolated cheilectomy or involved revision surgery of the first metatarsophalangeal joint after isolated cheilectomy, evaluated patients at mean follow-up ≥ 12 months' duration, and included details of complications. Twenty-three studies, describing 706 cheilectomies, met the inclusion criteria, with 62 (8.8%) undergoing surgical revision in the form of arthrodesis (n = 23), no mention of revision procedure (n = 17), interpositional arthroplasty (n = 13), silicone implant arthroplasty (n = 4), Keller resection arthroplasty (n = 3), or repeat cheilectomy (n = 2). Twelve studies specified the grade of Hallux Rigidus as: 103 (19.9%) grade 1, 210 (40.6%) grade II, 189 (36.6%) grade III, and 15 (2.9%) grade IV. Six studies indicated the number of cheilectomies that required revision surgery as: 2 (20%) grade I, 8 (14.8%) grade II, 12 (9.1%) grade III, and 5 (55.6%) grade IV. These results make clear the low incidence of revision surgery after cheilectomy for Hallux Rigidus. Therefore, cheilectomy should be considered a first-line surgical treatment for Hallux Rigidus. There remains a need for methodologically sound prospective cohort studies that focus on the use of cheilectomy for specific grades of Hallux Rigidus.
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The Need for Surgical Revision after Isolated Valenti Arthroplasty for Hallux Rigidus: A Systematic Review
Journal of Foot & Ankle Surgery, 2010Co-Authors: Thomas S RoukisAbstract:Abstract Isolated Valenti arthroplasty has been proposed for treatment of moderate to severe Hallux Rigidus because of the perceived safety and efficacy. Furthermore, it has been proposed that undergoing isolated Valenti arthroplasty does not prevent the ability to perform revision surgery consisting of Keller resection arthroplasty, prosthetic implant arthroplasty, or arthrodesis. The author undertook a systematic review of electronic databases and other relevant sources to identify material relating to the need for surgical revision after isolated Valenti arthroplasty for Hallux Rigidus. Information from peer-reviewed journals as well as non–peer-reviewed publications, abstracts, and posters was also considered. In an effort to procure the highest quality studies available, studies were eligible for inclusion only if they involved consecutively enrolled patients undergoing isolated Valenti arthroplasty, if they evaluated patients in person at mean follow-up ≥12 months' duration, and if they included details of complications after Valenti arthroplasty requiring surgical intervention. Three studies involving isolated Valenti arthroplasty were identified that met the inclusion criteria. Therefore, a total of 44 isolated Valenti arthroplasties were identified that met the inclusion criteria, with 2 (4.6%) undergoing surgical revision in the form of Keller resection arthroplasty (n = 1) and 1 plantarflexory base osteotomy (n = 1). No studies provided detailed information regarding complications specific to the exact grade of Hallux Rigidus in patients who underwent isolated Valenti arthroplasty. The results of this systematic review make clear the low incidence of revision surgery required after isolated Valenti arthroplasty for Hallux Rigidus. However, there is still a need for methodologically sound prospective cohort studies that focus on the use of isolated Valenti arthroplasty for specific grades of Hallux Rigidus and compare this procedure with other accepted forms of surgical treatment for moderate to severe Hallux Rigidus.
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metatarsus primus elevatus in Hallux Rigidus fact or fiction
Journal of the American Podiatric Medical Association, 2005Co-Authors: Thomas S RoukisAbstract:Two hundred seventy-five lateral weightbearing radiographs of isolated pathology were reviewed and stratified into Hallux Rigidus (n = 100), Hallux valgus (n = 75), plantar fasciitis (n = 50), and Morton’s neuroma (n = 50) groups. The patient population consisted of healthy individuals with no history of foot trauma or surgery. The first to second metatarsal head elevation, Seiberg index, first to second sagittal intermetatarsal angle, first to fifth metatarsal head distance, and Hallux equinus angle were measured in each population. Statistically significant differences were found between the Hallux valgus, plantar fasciitis, and Morton’s neuroma populations and the Hallux Rigidus population, which showed greater elevation of the first metatarsal relative to the second for each radiographic measurement technique. In the Hallux Rigidus population, there was a statistically significant difference between grade II and grades I and III regarding the first to fifth metatarsal head distance (greater in grade I...
Benjamin R Williams - One of the best experts on this subject based on the ideXlab platform.
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surgical management of Hallux Rigidus
Journal of The American Academy of Orthopaedic Surgeons, 2012Co-Authors: Jonathan T Deland, Benjamin R WilliamsAbstract:Hallux Rigidus is the most common degenerative joint pathology of the foot. Untreated, it may result in notable limitations in gait, activity level, and daily function. Positive outcomes can be achieved with nonsurgical management; surgery is recommended for the sufficiently symptomatic patient for whom nonsurgical measures are unsuccessful. Surgery is selected based on grade of involvement. Early to mid-stage Hallux Rigidus is best managed with cheilectomy or cheilectomy and proximal phalanx osteotomy. Arthrodesis and arthroplasty are reserved for late-stage Hallux Rigidus.
