Splay Foot, Hallux valgus, and Hallux Rigidus

Author(s):  
N. Gould
2020 ◽  
pp. 107110072096883
Author(s):  
Maria Tiscar Garcia-Ortiz ◽  
Jose Juan Talavera-Gosalbez ◽  
Lorena Moril-Peñalver ◽  
Maria Dolores Fernandez-Ruiz ◽  
Carolina Alonso-Montero ◽  
...  

Background: The purpose of this study was to compare the clinical outcomes after first metatarsophalangeal (MTP) joint arthrodesis for hallux rigidus between patients who underwent primary arthrodesis and those who had had a prior surgery for hallux valgus. Methods: Our design was a retrospective cohort study comparing 29 patients who underwent primary arthrodesis (primary group) and 34 patients with hallux rigidus after hallux valgus surgery (secondary group). The clinical assessment included the American Orthopaedic Foot & Ankle Society (AOFAS) score and a visual analog scale (VAS) for pain. Radiological evaluation was also performed. Overall, the mean postoperative follow-up was 3.4 (range, 2-5) years. Results: At final follow-up, AOFAS and VAS pain scores significantly improved in both groups ( P = .001). However, the mean AOFAS ( P = .001) and VAS pain ( P = .008) scores were significantly better in the primary group than in the secondary group. Radiologically, there were no significant differences between the groups in any angle after arthrodesis. Revision surgeries were not required in the primary group. In the secondary group, there was 1 revision due to deep infection, and 3 other patients required dorsal plate removal. Excluding plate removal, the Kaplan-Meier survival at 3 years was not significantly different between groups ( P = .775). Conclusion: Although arthrodesis of the first MTP joint was an effective procedure for hallux rigidus, the clinical outcomes in patients who had prior hallux valgus surgery were worse than those for patients who underwent primary surgery for hallux rigidus. Level of Evidence: Level III, retrospective cohort study.


Author(s):  
Andrew H.N. Robinson ◽  
Maneesh Bhatia

♦ The aim of modern forefoot surgery is to refunction the first ray, and balance the lesser rays around it♦ The indications for surgery in hallux valgus are of pain over the bunion, or of pain with subluxation or dislocation of the lesser rays as a result of first ray insufficiency♦ Hallux valgus surgery aims to reposition the metatarsal head over the sesamoids whilst maintaining length. The osteotomy should be stable to allow early mobilization♦ The mainstays of the surgical treatment of hallux rigidus are dorsal cheilectomy and fusion of the first MTPJ♦ 96% excellent and good results in reconstruction of the rheumatoid forefoot have been reported with fusion of the first MTPJ and resection of the lesser metatarsal heads.


1952 ◽  
Vol 34-B (3) ◽  
pp. 366-385 ◽  
Author(s):  
George Bonney ◽  
Ian Macnab
Keyword(s):  

2005 ◽  
Vol 95 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Thomas S. Roukis

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 II) and the hallux equinus angle (lower in grade II). A review of the literature and comparison with historical controls reveals that metatarsus primus elevatus exists in hallux rigidus and is greater than that found in hallux valgus, plantar fasciitis, and Morton’s neuroma groups. (J Am Podiatr Med Assoc 95(3): 221–228, 2005)


Author(s):  
Mario Alberto Madrid Pérez ◽  
Javier Bayod López

Hallux valgus and hallux rigidus are the most common pathologies in the first ray of the foot. Arthroplasty can restore the mobility of the joint but is a destructive procedure. This paper presents three finite element analysis of the foot studying two different kinds of arthroplasty.


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