A variety of treatments are recommended for
hallux rigidus. These include
arthrodesis of the first metatarsophalangeal joint and dorsal wedge
osteotomy of the proximal phalanx. This latter operation is not commonly performed in adults. A retrospective review of a series of 10
osteotomies and 20
arthrodeses after an average of 12 years for
hallux rigidus in the adult was undertaken. Patients were assessed at a follow-up clinic and their foot pressures were analyzed. Although the two groups were not matched, some conclusions could be drawn. Both operations were successful in terms of
pain relief. Complications were more common after
arthrodesis.
Callosities were more common after
arthrodesis. A greater duration of load occurs toward the fifth metatarsal after
arthrodesis. A greater force occurs under the first metatarsal after an
osteotomy rather than an
arthrodesis. It was concluded that the dorsal wedge
osteotomy is an alternative operation for
hallux rigidus in the adult, provided that there is some plantarflexion possible at the metatarsophalangeal joint. It is recommended as a procedure to preserve movement at the metatarsophalangeal joint to prevent
callosities. If the
osteotomy fails to relieve symptoms, then an
arthrodesis can be performed as a salvage procedure.