Hallux rigidus

Abstract

Hallux rigidus is a common disorder of multifactorial etiology and highly disabling in many cases. Factors associated with the development of the condition include trauma, particularly in cases of unilateral involvement, the shape of the metatarsophalangeal joint and shortening of the soft-tissue structures of the posterior chain. Excessive length and elevation of the first metatarsal are factors that have also been associated with the disorder in some studies. Conservative treatment may provide temporary symptom relief, especially in the early stages, but cannot eliminate or reduce established degenerative changes. Surgical treatment is guided by the patient's characteristics and expectations, as well as the clinical and radiographic stage of the disorder. Joint-preserving procedures, such as metatarsal and proximal phalanx osteotomies, are the preferred approach for less severe grades of the disorder, whereas interposition arthroplasty and arthrodesis are indicated for more advanced disease. Provided that technical indications are followed, good to excellent results are expected in the majority of the cases.