Proximal Phalanx Osteotomy for the Surgical Treatment of Hallux Rigidus

Thomas, Patrick J.; Smith, Ronald W.

doi:10.1177/107110079902000102

Cited by 67 publications

(36 citation statements)

References 9 publications

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“…A combined cheilectomy and proximal phalanx osteotomy can be performed [40]. In some reports the combined procedure of cheilectomy and proximal phalanx osteotomy gave better post-operative results than a cheilectomy alone [47]. Cheilectomy alone has the advantage of a shorter procedure with no retained hardware while a cheilectomy with a proximal phalanx osteotomy has some additional possible complications such as possible intra-operative damage to soft tissues, tendons, ligaments, valgus deformity, malunions, and nonunions.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcome Analysis of Hallux Rigidus Patients Undergoing Cheilectomy vs. Cheilectomy and Proximal Phalanx Osteotomy: A Patient’s Perspective

Warganich¹,

Weksler²,

Harris³

2014

Orthop Muscul Syst

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Background: The primary aim of this study is to evaluate the functional outcomes of two surgical treatment groups with hallux rigidus. Our goal was to better understand the post-surgical outcomes between the two treatment groups from a practical, patient-centered point of view. Methods: A retrospective case series of 63 patients with hallux rigidus undergoing cheilectomy (C group) or a cheilectomy plus proximal phalanx osteotomy (CPP group) over a 4-year period with a minimum clinical follow up of 12 months. Evaluation of the study was based on satisfaction scores, VAS score, functional outcomes, and radiographs. Results: There were 32 patients in the C group and 31 in the CPP group. The median months to "100% recovery" was 3.5 months in the C group vs. 9 months for the CPP group. Time to normal shoes and overall satisfaction with either surgery was nearly identical in both groups (30 days for C vs. 28 days for CPP and a mean satisfaction score of 8.4 for group C and 8.2 for group CPP). Both treatment groups had similar percentages of patients report less post-operative pain than expected (34% C vs. 33% CPP). A higher percentage of patients in the C group (56%) reported more pain than expected compared to the CPP group (40%). Also in both groups the VAS pain level decreased significantly. Discussion: In our study, we found that although CPP is a longer procedure, patients had an earlier return to full weight bearing but a much longer subjective, patient reported "100% recovery." However, the time to regular shoes remained the same in each group and overall means satisfaction score was similar. Interestingly, more patients in the cheilectomy only group reported their post-op pain to be higher than expected suggesting patients were underestimating their post-op course or receiving sub-optimal pre-operative counselling.

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Section: Discussionmentioning

confidence: 99%

Functional Outcome Analysis of Hallux Rigidus Patients Undergoing Cheilectomy vs. Cheilectomy and Proximal Phalanx Osteotomy: A Patient’s Perspective

Warganich¹,

Weksler²,

Harris³

2014

Orthop Muscul Syst

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“…Thomas and Smith retrospectively reviewed 17 patients with grade I and II radiographic hallux rigidus at average 2.5-year follow-up and found a 99% satisfaction rate without any complications or repeat surgery. 17 O’Malley retrospectively examined 81 patients with grade III radiographic hallux rigidus and reported 85% satisfaction after cheilectomy with a Moberg osteotomy. 18 Four (4.9%) patients required conversion to an arthrodesis and no patients developed IP joint arthritis.…”

Section: Operative Managementmentioning

confidence: 99%

Hallux rigidus

Baumhauer

2017

EFORT Open Reviews

111

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An estimated 40% of the US population have foot problems.Of all patients aged over 50 years, 2.5% report degenerative arthritis of the first metatarsophalangeal (MTP) joint, termed ‘hallux rigidus’. First MTP osteoarthritis is the most common arthritic condition in the foot.Progression of great toe arthritis is associated with pain and loss of motion. Non-surgical intervention begins with shoe modifications and orthotics designed to limit MTP motion.In patients with mild arthritis, operative procedures focus on removing excess osteophytes (cheilectomy) to prevent dorsal impingement with or without a concomitant osteotomy (Moberg) to improve or shift range of motion into a less painful arc.In patients with more advanced arthritis, operative management has centred on arthrodesis of the first MTP joint.A recent Level 1 study shows excellent function and pain relief with a small hydrogel hemi-implant into the metatarsal headMultiple joint-sparing procedures such as joint arthroplasty or resurfacing have been described with inconsistent results. Cite this article: EFORT Open Rev 2017;2:13–20. DOI: 10.1302/2058-5241.2.160031

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“…Verschiedene Korrekturosteotomien eignen sich für jüngere Patienten unter 60 Jahren mit weniger starker Arthrose und geringerer Schmerzausprägung [90]. Bei starken Schmerzen ist eine alleinige oder zusätzliche Cheilotomie angezeigt [91,92]. Ist in dieser Gruppe die Arthrose ausgeprägt, bringt eine Arthrodese gute Ergebnisse [93].…”

Section: Hallux Rigidusunclassified

Differenzialdiagnostik manualmedizinischer Syndrome der unteren Extremität unter Einbeziehung osteopathischer Verfahren

Buchmann

Arens²,

Harke³

et al. 2013

Phys Rehab Kur Med

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Die differenzialdiagnostische Beurteilung schmerzhafter funktioneller Störungen der unteren Extremität ist in der Praxis ein häufiges Problem. Die manualmedizinische Diagnostik kann hier einen wertvollen Beitrag in der Abgrenzung von struktureller und funktioneller Pathologie leisten. Manualmedizinische therapeutische Maßnahmen scheinen für akute und perakute Beschwerden effektiv zu sein. Die Manipulation und Mobilisation myofaszialer Störungen ist entweder Therapie der 1. Wahl oder wird begleitend bei primär orthopädischer oder internistischer Erkrankung eingesetzt. Im folgenden Beitrag werden manualmedizinische Syndrome vorgestellt, die Befundhäufungen aus dem muskuloskeletalem System zusammenfassen. Das erleichtert nicht nur die primäre differenzialdiagnostische Beurteilung, sondern ebenfalls die Therapieplanung. Die Kombination mit den osteopathischen Verfahren ist dabei sehr gewinnbringend. Eine notwendige fachärztliche Differenzialdiagnostik bleibt unumgänglich. Abstract !The differential diagnostic evaluation of painful functional disorders of the lower extremities is in practice very often. The manual medical diagnosis can make here a valuable contribution in the determination of structural and functional pathology. Manual medical therapies seems to be effective for acute and peracute complaints. The mobilization and manipulation (thrust technique) of myofascial restrictions are either the first choice therapy or were alternatively be used concomitantly in orthopedic or internal disorders. In the following review manual medical syndromes are presented that summarize the findings from the musculoskeletal system. This alleviated the primary differential diagnostic evaluation, as well as treatment planning. The combination with osteopathic methods is very profitable. A necessary specialist differential diagnosis remains essential.

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Proximal Phalanx Osteotomy for the Surgical Treatment of Hallux Rigidus

Cited by 67 publications

References 9 publications

Functional Outcome Analysis of Hallux Rigidus Patients Undergoing Cheilectomy vs. Cheilectomy and Proximal Phalanx Osteotomy: A Patient’s Perspective

Functional Outcome Analysis of Hallux Rigidus Patients Undergoing Cheilectomy vs. Cheilectomy and Proximal Phalanx Osteotomy: A Patient’s Perspective

Hallux rigidus

Differenzialdiagnostik manualmedizinischer Syndrome der unteren Extremität unter Einbeziehung osteopathischer Verfahren

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