Treatment of Advanced Stages of Hallux Rigidus with Cheilectomy and Proximal Phalangeal Osteotomy: Surgical Technique.

Elliott, Andrew J; Sayres, Stephanie C; O'Malley, Martin J · JBJS Essent Surg Tech · 2014

case_series · Level IV

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Abstract

We believe that a combination of cheilectomy and proximal phalangeal osteotomy can be used successfully (with an 85% satisfaction rate<sup>1</sup>) in patients with advanced hallux rigidus, including those in whom it is classified as Hattrup and Johnson<sup>2</sup> Grade III or as Coughlin and Shurnas<sup>3</sup> Grade III or IV (extensive degeneration of the joint involving >50% of the articular surface). Begin with a dorsal approach to the first metatarsophalangeal joint and phalanx. Remove osteophytes and the dorsal third of the first metatarsal head. Perform a 3-mm dorsal-based closing-wedge osteotomy of the proximal phalanx. Close the metatarsophalangeal joint capsule and skin. We reviewed the results in eighty-one patients with advanced hallux rigidus who were treated with a combination of cheilectomy and proximal phalangeal osteotomy. IndicationsContraindicationsPitfalls & Challenges.