Joint preservation in hallux rigidus: evaluating the efficacy of modified chevron osteotomy with extensive cheilectomy.

Abstract

Hallux rigidus is a degenerative condition of the first metatarsophalangeal joint, more frequently affecting females and individuals over 40 years. Various surgical options exist, but no prior studies have reported outcomes for distal shortening chevron osteotomy combined with extensive dorsal cheilectomy. To evaluate the clinical and functional outcomes of patients with hallux rigidus treated with distal shortening chevron osteotomy and extensive dorsal cheilectomy. Retrospective case series. A total of 50 patients (51 feet) underwent surgery between 2015 and 2022. One patient had bilateral involvement. The mean age was 49.37 years; 46 % were male and 54 % female. Mean follow-up was 46.57 months (range, 6-81 months). Patients were assessed preoperatively and after surgery using the American Orthopaedic Foot & Ankle Society (AOFAS) score, range of motion (ROM), Visual Analogue Scale (VAS), and Foot and Ankle Ability Measure (FAAM). Postoperative scores demonstrated statistically significant improvements across all measures. Patients reported decreased pain, improved joint mobility, and enhanced function. The majority expressed satisfaction and indicated a willingness to undergo the procedure again. Distal shortening chevron osteotomy with extensive dorsal cheilectomy is a safe and effective surgical option for Coughlin grades I-III hallux rigidus. This technique yields consistent improvements in pain, mobility, and function, with high patient satisfaction.