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2264 pages added, reviewed or updated during the last month (last updated: 21/4/2021)


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treatment

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Hallux rigidus may be treated conservatively or by surgery.

Conservative treatment:

  • a rigid metatarsal bar attached to the sole of the shoe takes the strain off the first metatarsophalangeal joint
  • cortisone injections can provide relief although this is often short term (1)

Surgical treatment:

  • generally divided into two groups (joint-sparing and joint-destructive)
    • debridement of the excessive bone including the dorsal aspect of the metatarsal head (cheilectomy) can be extremely successful
      • option for patients with a rigid joint but pain from the dorsal prominence in shoes alone
      • addition of a dorsiflexion osteotomy of the proximal phalanx of the hallux (Bonney–Kessel procedure) can improve function/reduce discomfort further
    • Keller's operation (Keller's arthroplasty)
      • debridement and resection of the base of the proximal phalanx
      • remains an extremely successful procedure in the right patient
    • arthrodesis
      • effective for pain relief but will limit shoe choice, causes transfer of load to the lateral aspect of the foot and will significantly alter function in those patients that have a degree of motion preoperatively
      • arthrodesis should be performed in slight flexion to accommodate the patient's normal footwear
  • replacement of the joint with a silastic spacer may relieve pain and increase the range of dorsiflexion but a foreign body reaction may occur later

Reference:

  1. ARC. Common foot disorders. Hands On 2006;10:1-6.

Last reviewed 01/2018

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