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Online ISSN 1827-1707
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Bosa G., Sabra M., Ala C., Indemini E.
Divisione di Ortopedia e Traumatologia Ospedale Maggiore di Chieri, Torino
Aim. Hallux rigidus is a condition that can cause considerable debilitation, perhaps greater than does hallux valgus, because of severe stiffness in more serious cases.
Methods. For the past 2 years at our unit, severe cases of hallux rigidus have been treated with resection arthroplasty of the first metatarsophalangeal joint as suggested by Valenti in 1987. The technique entails a V-osteotomy which on the sagittal plane is open on the dorsal aspect and involves two thirds of the head of the first metatarsus and the base of the proximal phalanx of the great toe. Insertion of the short flexor of hallux and the plantar meta-tarsal ligament is preserved to ensure sesamoid function.
Results. To evaluate the technique, 13 patients were reassessed over a mean follow-up of 13 months for restoration of joint motion, pain, postoperative course and complications, radiologic outcome and patient satisfaction.
Conclusions. Early loading, restored joint motion, marked reduction in pain without significant loss in push off from the toe, even in this small series, suggest that the technique offers a valuable alternative to conventional methods such as arthrodesis, interpositional arthroplasty or wide surgical resection, until more reliable prosthetic devices are developed.