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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 August;50(4):139-46
Valenti's hinge arthroplasty for allux rigidus treatment
Rossi Urtoler E., Squarzina B., Boschi S., Folloni A., Berlen V.
Background. Hallux rigidus is the clinical manifestation of a degenerative disease of the first metatarsophalangeal joint that leads to arthrosis, causing a progressive impairment of finger extension until ankylosis in a flexed position. This pathology is the most common painful affection of the first finger after hallux valgus; it can be idiopathic or secondary and is divided into three stages according to Regnauld's classification.
Methods. Personal experience in the treatment of Regnauld' s second and third stage using Valenti's hinge arthroplasty procedure is reported. This technique consists in the excision of a ninety degree dorsally based wedge osteotomy, including the first metatarsal head and the basis of the first phalanx of the hallux; osteotomy surfaces are then covered by articular capsule whose dorsal layer is sutured to the plantar one. Eighteen hinge arthoplasties have been performed from 1987 to 1995 in 15 patients, 11 females and 4 males, mean aged 63,4 years old. Every patient came back to control and the mean follow-up was 4,6 years.
Results. The results have been evaluated by a score system which considers the presence of pain and dorsal passive motion of the first metatarsophalangeal joint; they have been considered excellent in eight cases, good in 6, fair in 3 and unsatisfying in only one case.
Conclusions. Valenti's hinge arthroplasty is considered, therefore, a simple and reliable technique and a good solution for the treatment of 2nd and 3rd stage of hallux rigidus.