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Hallux Rigidus

Hallux Rigidus is essentially the end-point of hallux limitus. Unlike hallux limitus where there is still some motion in the joint at the base of the great toe (the first metatarsal phalangeal joint, or 1st MPJ), with Hllux Rigidus there is very little, if any, motion at the joint. This prevents the great toe from being able to bend while walking and the joint itself may be very painful.

There may be very little cartilage remaining on either surface of the joint and sometimes small fragments of bone may be found floating in the joint during surgery. Bone spurs are often seen at either side of the joint.

Hallux Rigidus may occur following an injury to the metatarsal phalangeal joint, such as an old fracture or impaction injury, or may be a result of an abnormally elevated first metatarsal bone which prevents the great toe from moving over the metatarsal bone when walking. It may also be a result of osteoarthritis (sometimes referred to as overuse arthritis).

There are ways in which hallux limitus can be managed and made more comfortable in shoes. These include:
Splinting
Padding
Wearing rocker bottom shoes
Cortisone injections
Use of oral anti-inflammatory medication, such as Ibuprofen.
Additionally, custom orthotics may be helpful to control movements of the foot that may contribute to worsening of the deformity over time. However, they will not correct the deformity that is already present.

If conservative care fails to alleviate the pain, then surgery to fuse the joint may be pursued. This is an outpatient surgical procedure which takes about an hour to complete. Ask your podiatrist about your surgical options as well as the necessary recovery.

If you would like to watch a video on 1st MPJ fusion surgery, please follow this link:

“First Metatarsophalangeal Joint Arthrodesis” 1stMTPFusion

(This video includes live operative footage and may be disturbing to some audiences.)