Hallux rigidus is the term used to describe end-stage limited range of motion of the great toe joint. Hallux rigidus is often referred to as the final stage (stage 4) of hallux limitus. Hallux limitus is a progressive degenerative change in the 1st mpj.

Treatment of hallux rigidus

Conservative care of hallux rigidus focuses on the use of pads to limit the range of motion of the great toe or devices to stiffen the shoe.  Turf toe straps are a great short term aid for symptoms of hallux limitus and hallux rigidus.  Turf toe plates and carbon spring plates are two examples of inserts that can be used to stiffen the shoe.  Shoe modifications are also used to decrease bending of the forefoot.  The most common modification is called an anterior rocker sole, seen at right.

Surgical care of hallux rigidus may include a Keller bunionectomy, great toe fusion or implant arthroplasty.  A Keller bunionectomy is an old procedure that utilizes the capsule of the great toe joint to create a new joint.  The capsule, or lining of the joint is interposed in the position where the joint is resected.  The disadvantage of the Keller bunionectomy is that the great toe is usually much shorter and floppy post-op. 

Fusion of the great toe joint is accomplished by resection of the joint and fixation of the joint with crossed screws or a plate.  A bone graft is often used to supplement shortening created when the joint is resected.  The bone graft can be from bone bank bone or from the iliac crest (crest of the pelvis).  Fusion of the great toe joint requires a 6-8 week period of non-weight bearing for proper healing.

Implant arthroplasty involves resection of the joint and replacement of the joint with a flexible hinge.  The following pictures show the steps used to perform implant arthroplasty of the great toe joint.  Image 1 shows the pre-op planning and location of the incision.  Images 2 and 3 show dissection of the joint and removal of arthritic spurring surrounding the the joint.  Image 4 shows the trial implant sizers.  Images 5-8 show remodeling of the joint with preparation of the implant site.  Image 9-12 shoe placement of the implant and final closure.  This procedure is performed at a hospital or surgery center under general anesthesia or local anesthesia with sedation.  The procedure takes about and hour to complete.  Patients can bear full weight on the foot immediately following surgery.

For additional information regarding the onset and development of hallux rigidus, please refer to our pages on hallux limitus.

There is no additional information for this topic.  Please refer to our pages on hallux limitus.

There is no additional information for this topic.  Please refer to our pages on hallux limitus.

There is no additional information for this topic.  Please refer to our pages on hallux limitus.

There is no additional information for this topic.  Please refer to our pages on hallux limitus.

There is no additional information for this topic.  Please refer to our pages on hallux limitus.

• Bunion

• Sesamoiditis

• Turf Toe

• Hallux Limitus

• Arthritis Of The Foot and Ankle

This article was written by Jeffrey A. Oster, DPM and last updated 6/12/07.

There are no additional references for this topic.