Abstract
The hallux rigidus is a degenerative osteoarthritis of the first metatarsophalangeal (MTP) joint, considered the most common arthritic condition in the foot. On clinical examination, an MTP joint of the hallux that is larger than normal may be encountered, and the interphalangeal joint is hyperextended, with a plantar callus at the base of the distal phalanx. Palpation elicits dorsal tenderness, crepitus, and limited mobility, and we can support our clinical findings in patients with imaging methods, helping us in the accuracy of the diagnosis and the preoperative planning if necessary. The aim of treatment is to decrease the local inflammatory process and help to decrease the extension forces of the metatarsophalangeal joint. Initially all patients are treated with nonoperative treatment, although some of them will need operative treatment. Hallux rigidus surgical treatment has been somewhat controversial, with many different surgical treatments described to date, which can be divided into two groups in relation to the treatment of the MTP joint: destructive and preserving. The choice of the procedure still is an individual decision of the treating surgeon, and nowadays percutaneous osteotomy has proven to be a valid technique that yields results similar to open osteotomy for the treatment of forefoot problems. In this chapter, we describe our minimally invasive technique for hallux rigidus surgical treatment.
Pau Golanó: deceased
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Yee G, Lau J. Current concepts review: hallux rigidus. Foot Ankle Int. 2008;29(6):637–46.
Davies-Colley MR. Contraction of the metatarsophalangeal joint of the great toe. BMJ. 1887;1:728.
Cotterill JM. Stiffness of the great toe in adolescents. BMJ. 1888;1:1158.
De Prado M, Ripoll P, Golanó P. Minimally invasive management of hallux rigidus. In: Maffulli N, Easley M, editors. Minimally invasive surgery of the foot and ankle. London: Springer; 2010. p. 75–88.
Calvo A, Viladot R, Gine J, Alvarez F. The importance of the length of the first metatarsal and the proximal phalanx of hallux in the etiopathogeny of the hallux rigidus. Foot Ankle Surg. 2009;15(2):69–74.
Bouaicha S, Ehrmann C, Moor BK, Maquieira GJ, Espinosa N. Radiographic analysis of metatarsus primus elevatus and hallux rigidus. Foot Ankle Int. 2010;31(9):807–14.
Perry J. Gait analysis: normal and pathological function. Thorofare: SLACK; 1992.
DuVries HL. Hallux rigidus (hallux limitus). In: DuVries HL, editor. Surgery of the Foot St. Louis: Mosby; 1959. p. 392–9.
Zgonis T, Jolly GP, Garbalosa JC, Cindric T, Godhania V, York S. The value of radiographic parameters in the surgical treatment of hallux rigidus. Foot Ankle Surg. 2005;44(3):184–9.
Beeson P, Phillips C, Corr S, Ribbans W. Classification systems for hallux rigidus: a review of the literature. Foot Ankle Int. 2008;29(4):407–14.
Polzer H, Polzer S, Brumann M, Mutschler W, Regauer M. Hallux rigidus: Joint preserving alternatives to arthrodesis – a review of the literature. World J Orthod. 2014;5(1):6–13.
Coughlin MJ, Shurnas PS. Hallux rigidus. Grading and long-term results of operative treatment. J Bone Joint Surg Am. 2003;85-A(11):2072–88.
Pons M, Alvarez F, Solana J, Viladot R, Varela L. Sodium hyaluronate in the treatment of hallux rigidus. A single-blind, randomized study. Foot Ankle Int. 2007;28(1):38–42.
Herrera-Perez M, Andarcia-Banuelos C, de Bergua-Domingo J, Paul J, Barg A, Valderrabano V. Proposed global treatment algorithm for hallux rigidus according to evidence-based medicine. Rev Esp Cir Ortop Traumatol. 2014;58(6):377–86.
McNeil DS, Baumhauer JF, Glazebrook MA. Evidence-based analysis of the efficacy for operative treatment of hallux rigidus. Foot Ankle Int. 2013;34(1):15–32.
Taranow WS, Moore JR. Hallux rigidus: a treatment algorithm. Tech Foot Ankle Surg. 2012;11(2):65–73.
Nilsonne H. Hallux rigidus and its treatment. Acta Orthop Scand. 1930;1:295–303.
Mann RA, Clanton TO. Hallux rigidus: treatment by cheilectomy. J Bone Joint Surg Am. 1988;70(3):400–6.
Moberg E. A simple operation for hallux rigidus. Clin Orthop Relat Res. 1979;142:55–6.
Brookes M, Helal B. Primary osteoarthritis, venous engorgement and osteogenesis. J Bone Joint Surg Br. 1968;50(3):493–504.
Pittman SR, Burns DE. The Wilson bunion procedure modified for improved clinical results. J Foot Surg. 1984;23(4):314–20.
Watermann H. Die arthritis deformans Grosszehen-Grundgelenkes. Orthop Chir. 1927;48:346–55.
Cavolo DJ, Cavallaro DC, Arrington LE. The Watermann osteotomy for hallux limitus. J Am Podiatry Assoc. 1979;69(1):52–7.
Bauer T, de Lavigne C, Biau D, De Prado M, Isham S, Laffenetre O. Percutaneous hallux valgus surgery: a prospective multicenter study of 189 cases. Orthop Clin North Am. 2009;40(4):505–14. ix.
De Prado M, Ripoll PL, Golanó P. Hallux rigidus. In: De Prado M, Ripoll PL, Golanó P, editors. Minimally invasive foot surgery: surgical techniques, indications, anatomical basis. Barcelona: About your health publishers; 2009. p. 111–24.
De Prado M, Ripoll PL, Golanó P. Hallux rigidus. In: De Prado M, Ripoll PL, Golanó P, editors. Cirugía percutánea del pie. Técnicas quirúrgicas Indicaciones. Bases anatómicas. Barcelona: Elsevier-Masson; 2003. p. 99–112.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this entry
Cite this entry
De Prado, M., Cuervas-Mons, M., De Prado, V., Golanó, P. (2016). Minimally Invasive Management of Hallux Rigidus. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, Cham. https://doi.org/10.1007/978-3-319-34109-5_69
Download citation
DOI: https://doi.org/10.1007/978-3-319-34109-5_69
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-34107-1
Online ISBN: 978-3-319-34109-5
eBook Packages: MedicineReference Module Medicine