Tricorrectional osteotomy for the correction of late-stage hallux limitus/rigidus

Abstract

The authors propose the use of the tricorrectional osteotomy for treatment of severe hallux limitus/rigidus as an alternative to joint-destructive procedures. A study of 19 patients with follow-up treatment ranges of 10 months to 6 years postoperatively was performed. Data were collected on preoperative and long-term postoperative x-rays, range of motion assessment, F-scan studies, and subjective patient questionnaires. High patient satisfaction along with increased range of motion, minimal complications, and an early return to activities make this an ideal procedure for grades II, III, and IV hallux limitus/rigidus.

A Retrospective Analysis of 772 Patients with Hallux Limitus

“…For conselVa1:ive treatment of iatr.ogenic ha.llllX limi.t.us, without an associated first metatarsal. elevatlls, con tinuous passive motion ha.q been beneficial to pa tients with adhesive capsulitis.27 Jo1 The results ach.ieved by Sel ner et a133 with this procedure show an avera.ge in crease of first met.at.a.rsophalangea.l joint dorsiflexion of 36.4 0 and an average joint space increase of 1.08 mm. Another .ioin1~preservation technique is a s::Igitt.a1 pla.ne Z-osteotomy of the proximal phalanx as de scribed by Kissel et aI.…”

Classification Systems for Hallux Rigidus: A Review of the Literature

“…54 It is recognized that the degree to which HR develops depends on many factors. 31 On the basis of empirical observations of the etiology of HR, authors have proposed several systems to stratify the severity of HR including two grades, 18,28,41 three grades, 2,9,14,17,22,23,26,38,43,47 four grades, 13,19,34,46,50,52,53 and five grades. 11,27 These have been based predominantly on radiological and/or clinical features combined to grade the degree of first MTP joint osteoarthritis.…”

“…Ronza et al 47 varies between studies. 11,29,50 • Number of grades in classification or their subdivision was not always explained. 16,22,31,40 • Inconsistent or inaccurate interpretation of 2 or combination of two or more systems.…”

First Metatarsophalangeal Joint Interpositional Arthroplasty Using a Meniscus Allograft for the Treatment of Advanced Hallux Rigidus

“…Operative procedures to address hallux rigidus are divided into jointpreservation and joint-destructive procedures. Joint-preservation procedures are cheilectomy, 7,15,[17][18][19][20][21][22][23][24][25][26][27][28] metatarsal osteotomies, 18,22,[29][30][31][32][33][34][35] phalangeal osteotomies, 10,[36][37][38][39][40][41] and chondroplasty. 22,42 Jointdestructive procedures are resectional/ excisional arthroplasty, 20,28,[43][44][45][46] interpositional implant arthroplasty, 27,[47][48][49][50][51][52][53][54][55][56] hemiarthroplasty,…”