Hallux equinus. The stages of hallux limitus and hallux rigidus

In this retrospective analysis of 772 patients with symptomatic hallux limitus, 428 patients (55%) were successfully treated with conservative care alone; of these 428 patients, 362 (84%) were treated with orthoses. Corticosteroid injections and a change in shoes allowed 24 patients (6% of conservatively treated patients) and 42 patients (10%), respectively, to have less discomfort and return to previous activity levels. Overall, 47% of the patients in this analysis were successfully treated with orthoses. Surgical procedures were performed on 296 patients (38% of all patients) who did not respond to conservative care. In this analysis, 48 of the patients (6% of all patients) who did not respond to conservative care either refused surgery or were not surgical candidates. These data are intended to provide podiatric physicians with expected outcomes for conservative care of hallux limitus. The etiology, symptoms, conservative management, and surgical treatments of hallux limitus and hallux rigidus are also reviewed. (J Am Podiatr Med Assoc 92(2): 102-108, 2002)

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Disorders of the First Ray: Part 2 Hypermobility, Functional Hallux Limitus, and Hallux Rigidus

Pathomechanics of Common Foot Disorders ◽

10.1007/978-3-030-54201-6_5 ◽

2020 ◽

pp. 139-168

Author(s):

Douglas H. Richie Jr

Keyword(s):

Hallux Rigidus ◽

Hallux Limitus ◽

First Ray

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An Assessment of Hallux Limitus in University Basketball Players Compared with Noncompetitive Individuals

Journal of the American Podiatric Medical Association ◽

10.7547/0003-0538-104.5.468 ◽

2014 ◽

Vol 104 (5) ◽

pp. 468-472 ◽

Cited By ~ 1

Author(s):

Paul Trégouët

Keyword(s):

Range Of Motion ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

Artificial Turf ◽

Basketball Players ◽

First Metatarsophalangeal Joint ◽

Hallux Limitus ◽

Significant Difference ◽

Turf Toe ◽

The Difference

BackgroundInjuries of the first metatarsophalangeal joint have lately been receiving attention from researchers owing to the important functions of this joint. However, most of the studies of turf toe injuries have focused on sports played on artificial turf.MethodsThis study compared the range of motion of the first metatarsophalangeal joint in collegiate basketball players (n = 123) and noncompetitive individuals (n = 123).ResultsA statistically significant difference (P < .001) in range of motion was found between the two groups. The difference between the two sample means was 21.35°.ConclusionsWith hallux rigidus being a potential sequela of repeated turf toe injuries, it seems likely that subacute turf toe injuries occur in basketball players, leading to degenerative changes that result in hallux limitus.

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Concept, etiology, and pathomechanics of hallux rigidus

Journal of the Foot & Ankle ◽

10.30795/jfootankle.2021.v15.1577 ◽

2021 ◽

Vol 15 (3) ◽

pp. 193-197

Author(s):

Manuel Monteagudo de la Rosa ◽

Ramón Viladot-Pericé

Keyword(s):

Positive Impact ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

Compensatory Mechanisms ◽

Level Of Evidence ◽

First Metatarsophalangeal Joint ◽

Functional Changes ◽

Hallux Limitus ◽

Sliding Mechanism ◽

Movement Mechanism

There is a continuous anatomical, functional and pathomechanical roadmap from functional hallux limitus to hallux rigidus. Although many etiologies for hallux rigidus have been studied it is very probable that it has a primary origin with less-than-ideal movement when we are born. Upon a restricted range of motion, symptoms may arise depending on the amount of work and how compensatory mechanisms work around the first metatarsophalangeal joint. Changes occurring at the joint that allow the transition from a sliding movement mechanism (physiological) to a rolling mechanism (pathological) may trigger anatomical and functional changes resulting in pain and dysfunction. Any surgical technique that is able to restore the sliding mechanism to the first metatarsophalangeal joint will have a positive impact on pain and function in a patient with a symptomatic functional hallux limitus/rigidus. Level of Evidence V; Therapeutic Study; Expert opinion.

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Hallux Abductus Interphalangeus in Normal Feet, Early-Stage Hallux Limitus, and Hallux Valgus

Journal of the American Podiatric Medical Association ◽

10.7547/0003-0538-104.2.169 ◽

2014 ◽

Vol 104 (2) ◽

pp. 169-173 ◽

Cited By ~ 9

Author(s):

Jose M. Castillo-Lopez ◽

Javier Ramos-Ortega ◽

Maria Reina-Bueno ◽

Gabriel Domínguez-Maldonado ◽

Inmaculada C. Palomo-Toucedo ◽

...

Keyword(s):

Hallux Valgus ◽

Early Stage ◽

Pearson Correlation ◽

Proximal Phalanx ◽

Correlation Coefficients ◽

Hallux Rigidus ◽

Distal Phalanx ◽

Control Group ◽

Hallux Limitus ◽

Early Stages

Background Excessive deviation of the distal phalanx in abduction frequently occurs in advanced stages of hallux rigidus but not in hallux valgus. Therefore, theoretically there should be no significant differences in the hallux interphalangeal angle (HIPA) between individuals with normal feet, those with hallux valgus, and those with mild hallux limitus. The objective of the present study was thus to determine if significant differences in HIPA exist in the early stages of hallux valgus or hallux limitus deformities. Methods The hallux interphalangeal angle was measured in three groups of participants: a control group with normal feet (45 participants), a hallux valgus group (49 participants), and a hallux limitus group (48 participants). Both of the pathologies were at an early stage. A dorsoplantar radiograph under weightbearing conditions was taken for each individual, and measurements (HIPA and hallux abductus angle [HAA]) were taken using AutoCAD (Autodesk Inc, San Rafael, California) software. Intergroup comparisons of HIPA, and correlations between HIPA, HAA, and hallux dorsiflexion were calculated. Results The comparisons revealed no significant differences in the values of HIPA between any of the groups (15.2 ± 5.9 degrees in the control group, 15.5 ± 3.9 degrees in the hallux valgus group, and 16.15 ± 4.3 in the hallux limitus group; P = 0.634). The Pearson correlation coefficients in particular showed no correlation between hallux dorsiflexion, HAA, and HIPA. Conclusions For the study participants, there were similar deviations of the distal phalanx of the hallux with respect to the proximal phalanx in normal feet and in feet with the early stages of the hallux limitus and hallux valgus deformities.

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Hallux Limitus/Hallux Rigidus

Textbook of Bunion Surgery ◽

10.1016/b978-0-7216-7784-2.50020-6 ◽

2001 ◽

pp. 371-410

Author(s):

Joshua Gerbert

Keyword(s):

Hallux Rigidus ◽

Hallux Limitus

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Management of Hallux Limitus with Distraction of the First Metatarsophalangeal Joint

Journal of the American Podiatric Medical Association ◽

10.7547/0950121 ◽

2005 ◽

Vol 95 (2) ◽

pp. 121-129 ◽

Cited By ~ 19

Author(s):

Leonard M. Talarico ◽

George R. Vito ◽

Larry Goldstein ◽

Adam D. Perler

Keyword(s):

External Fixator ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

Long Term Results ◽

Joint Function ◽

First Metatarsophalangeal Joint ◽

Hallux Limitus

This article describes a joint-preserving and joint-restoring procedure for the management of hallux limitus and hallux rigidus. The procedure uses a minirail external fixator to obtain distraction with or without arthrotomy of the first metatarsophalangeal joint. This procedure aims to restore joint function through elimination of the pathologic forces involved in hallux limitus and hallux rigidus. Both intrinsic and extrinsic muscular imbalances are reduced. Follow-up of 133 patients treated in this manner since 1997 demonstrates excellent long-term results. (J Am Podiatr Med Assoc 95(2): 121–129, 2005)

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Sagittal Plane Compensations for Artificially Induced Limitation of the First Metatarsophalangeal Joint

Journal of the American Podiatric Medical Association ◽

10.7547/0940269 ◽

2004 ◽

Vol 94 (3) ◽

pp. 269-274 ◽

Cited By ~ 28

Author(s):

Christine Hall ◽

Christopher J. Nester

Keyword(s):

Sagittal Plane ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

First Metatarsophalangeal Joint ◽

Hallux Limitus ◽

Metatarsophalangeal Joints

This study was undertaken to establish whether reduced dorsiflexion at the first metatarsophalangeal joint affects sagittal plane kinematics at the ankle, knee, and hip. Twenty individuals with symptom-free metatarsophalangeal joints were studied as they walked with and without an insole designed to restrict first metatarsophalangeal joint dorsiflexion. Sagittal plane kinematics at the ankle, knee, and hip were compared in the two conditions. When walking with the insole, the ankle was more dorsiflexed during late midstance and less plantarflexed during propulsion, the knee was more flexed during midstance, and the hip was less extended during late midstance. This evidence of a link between the first metatarsophalangeal joint and the kinematics of the proximal joints demonstrates the potential for the clinical entities of hallux rigidus and hallux limitus to influence gait and justifies more detailed study of this relationship. (J Am Podiatr Med Assoc 94(3): 269–274, 2004)

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