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Hallux Rigidus Print


Hallux rigidus is seen in the first metatarsphalengeal joint of foot. It is charecterized with pain and limitation of joint motion in the first metatarsophalengeal joint. Progressive joint degeneration and osteoarthritis are seen in Hallux rigidus disease.

What is the etiology of Hallux Rigidus?

Halluks rigidus is more common in patients with severe pes planus due to the excessive load on first metatarsophalengeal joint. People standing on their tiptoes most of the time, persons staying in crouched position are prone to develop hallux rigidus. Direct blows and traumas may also cause joint degeneration. Hallux rigidus is also common in rheumatoid arthritis and gout arthropaties.

What are the clinical findings of Hallux Rigidus?

Pain and activity limitation are the most common early complaints. Pain is felt worse in cold and rainy weathers. It is typical for the patients with Halluks rigidus to have pain in crouch position and during running due to the increase load to first metatarsophalengeal joint. Occasionally, patients may have swelling and redness in the joint following physical activity. in later stages, patients experince pain in rest too. Bony spurs cause shoe fitting problems. Patients are generally uncomfortable with shoes which are narrow,  front part pointing and elastic soles. Patients usually alter their walking pattern may occasionally limp..

How can Hallux Rigidus be diagnosed?

Hallux rigidus can be diagnosed with limitation of first metatarsophalengeal joint dorsiflexion which is between 55-70 degrees normally along with bone bump formation dorsal part of the joint. Radiographs may demostrate dorsal beaking in both metatarsal and phalengeal joint surfaces and joint space narrowing in severe cases.

How is Hallux Rigidus treated?

Rest, antiimflamatory medicine, ice application may alleviate  acute pain and swelling symptoms. Hard sole shoes are recommended in the early disease stages. Patients with hallux rigidus also benifit from shoes with large and high  toe box If the patient still has complaints despite the conservative treatment, surgical treatment may be planned.

What is the surgical treatment for Hallux Rigidus?

Removal of the bony spurs may help in the treatment of early stage diseases. Patients usually gain joint range of motion after surgery.

If  arthrosis developed,  treatment options would be whether arthrodesis of the joint or arthroplasty. Even though one may gain range of motion with prosthesis surgery, the complication rates and recurrent surgery risks are highe in athroplasty then arthrodesis.

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