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Hallux Limitus / Rigidus Surgery

Description

"Hallux Limitus" and "Hallux Rigidus" describe a pathological condition involving the first metatarsalphalangeal joint. Hallux limitus refers to a limited range of motion during functional use, such as walking and running especially on inclines. When the structural degeneration advances to the state where there is no motion of the first MTPJ at all, it is then called Hallux Rigidus.

Morphologic characteristics of Hallux Limitus are visible with the use of Radiography. A radiograph in the AP view would be needed to assess a relatively long first metatarsal in comparison to the lesser metatarsals. When viewed on a lateral radiograph, Hallux Limitus may be noted in correlation with an elevated 1st metatarsal, where either the entire metatarsal itself is abnormally elevated above the lesser metatarsals or simply the head itself is in a relatively dorsiflexed position over the shaft. Over time, Hallux Limitus can lead to the formation of an exostosis on the dorsal surface of the first metatarsal head and a painful swelling on the dorsal surface overlying the first metatarsal head.

When conservative care fails, surgical intervention may then be utilized. This procedure involves dissection through the capsule to the joint, followed by an adhesiotomy of fibrotic material on the articulating surface and cheilectomy of superfluous bone and cartilaginous formation. The elevated first metatarsal is brought to a plantar position by use of a variety osteotomy procedures which will result in the alignment of the first metatarsal head with the lesser metatarsals.

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