Retrospective analysis of surgical treatment of hallux rigidus/limitus: clinical and radiographic follow-up of hinged, silastic implant arthroplasty and cheilectomy.

Abstract

Many authors have hypothesized on the etiology of hallux limitus and have proposed grading systems for classifying the degree of first metatarsophalangeal joint derangement and dysfunction. Several opinions exist regarding surgical treatment, should a patient fail with conservative therapy. Hinged, Silastic implant arthroplasty and cheilectomy account for a significant proportion of procedures accomplished. However, little follow-up documents and critically analyzes the long-term results of these procedures. This study analyzes, retrospectively, the results of these procedures with a minimum follow-up of 46 months. Hinged, Silastic implant arthroplasty appears to be a safe, technically easy, efficacious procedure in the grade II to III lesion in patients of 60 years or older, in whom an active life-style is desired. Cheilectomy appears to be indicated in the patient with a classic grade I lesion, while its use in grade II lesions, especially in the presence of sesamoid disease, requires further investigation.