Cheilectomy, chondroplasty, and sagittal "Z" osteotomy: a preliminary report on an alternative joint preservation approach to hallux limitus.

Abstract

The surgical correction of hallux limitus can be most rewarding for both patient and surgeon when marked degenerative changes exist in older individuals. Many foot and ankle surgeons would perform an implant arthroplasty in a patient over 60 years of age with hallux limitus or rigidus. In a patient without gross first metatarsophalangeal joint arthrosis, but with limitation in range of motion, the literature is replete with biomechanically sound surgical options. However, surgical repair of the moderate-to-severe arthritic first metatarsophalangeal joint in younger individuals remains quite a challenge. The authors present the use of a sagittal plane "Z" osteotomy of the proximal phalanx along with cheilectomy and chondroplasty for the treatment of hallux limitus and rigidus in the young, active patient.