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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE
A Journal on Physiopathology and Surgery of the Foot
Indexed/Abstracted in: EMBASE, Scopus
Chirurgia del Piede 2009 August;33(2):85-90
Hallux rigidus iii degree: arthrodesis or biological arthroplasty? Case histories review and personal consideration
Morino L. 1,2, Cerlon R. 1,2, Errichiello C. 3, Versiglia F. 4, Rosso F. 4, Belsanti S. V. 4, Crova M. 2,4
1 AO CTO/M Adelaide, Torino, Italia
2 Dipartimento di Ortopedia Traumatologia e Medicina del Lavoro, Torino, Italia
3 Clinica Fornaca di Sessant, Torino, Italia
4 Università degli Studi di Torino, Italia
Aim. The study is directed to compare two groups of patients in order to attest the surgical operation that allows the best results understood like reduction of the pain, improvement of the deambulation and stability in the time of the obtained result.
Methods. From 1994 to 2005, 77 patients (for a total of 82 feet), with diagnosis of “hallux rigidus III° degree”, underwent an operation at “Chirurgia del Piede” of CTO, Turin, Italy. Arthroplasty of Valenti (60 cases) and arthrodesis (9 cases) have been the most performed surgical operations: the total of reassessed feet was 46 (40 arthroplasties and 6 arthrodeses). The patients in study have been object of a double evaluation, one of quantitative type (following the card of appraisal of the AOFAS) and one of qualitative type (using questions of subjective appraisal).
Results. Most of the data are clearly in favor of an improvement of the clinical conditions (general and local) after a surgical operation, either arthroplasty or arthrodesis. After arthroplasty patients express greater satisfaction, referring to preserved articular mobility between metatarsus and phalanx.
Conclusion. Biological arthroplasty of Valenti is the first-rate surgical operation because it allows to maintain a certain movement between metatarsus and phalanx: the residual possibility of movement allows a better control of pain, a better alignment, a better adaptability of the foot in the shoe, a lower stress for the adjacent joints, a lower overload on the first metatarsus and finally a lower metatarsalgia.