Percutaneous Treatment of Grade I/II Hallux Rigidus in Active Patients: Surgical Technique and Outcomes
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Abstract
Materials and Methods: We conducted a retrospective review of all patients diagnosed with mild to moderate hallux rigidus who underwent minimally invasive/percutaneous surgery, involving dorsal cheilectomy of the first metatarsal combined with a dorsal wedge osteotomy of the first metatarsal and proximal phalanx of the hallux, between June 2019 and June 2022. The minimum follow-up period was 12 months, with a maximum of 36 months.
Results: A total of 15 patients (19 feet) were included, with a mean age of 54 years (range: 38–71). The visual analog scale (VAS) score decreased from 7 preoperatively to 0.7 postoperatively (p < 0.05). Mean dorsiflexion increased from 30° to 49° (p < 0.05), while plantarflexion improved from 14° to 20° (p < 0.05). The mean AOFAS score increased from 60 (range: 52–68) preoperatively to 85 (range: 81–89) at the final follow-up (p < 0.001).
Conclusions: The minimally invasive approach—dorsal cheilectomy combined with dorsiflexion osteotomy of the distal metatarsal and proximal phalanx—appears to be a reliable long-term treatment for grade I/II hallux rigidus. This technique offers a safe and effective alternative for active patients, achieving optimal functional outcomes with minimal pain and only minor, common complications.
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