+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Dorsal wedge phalangeal osteotomy for grade II-III hallux rigidus in active adult patients



Dorsal wedge phalangeal osteotomy for grade II-III hallux rigidus in active adult patients



Foot and Ankle International 36(2): 188-196



The purpose of this study was to evaluate prospectively the results of the dorsal wedge phalangeal osteotomy for treating moderate hallux rigidus. The prospective study included 42 consecutive feet in 40 active patients, with an average age of 55.1 (range, 41-65) years. Clinical evaluation included American Orthopaedic Foot and Ankle Society (AOFAS) score, pain visual analog scale, range of motion, and subjective patient satisfaction. Radiographic evaluation was performed, including linear and angular measurements. The average follow-up was 2.7 (range, 2-3.8) years. The preoperative and postoperative mean AOFAS scores were 51.7 and 88.8, respectively (P = .001), and for pain VAS were 7.6 and 1.9, respectively (P = .001). Good and excellent results at final follow-up were seen in 34 feet. All patients returned to their previous activities. Satisfaction with surgery was good or excellent in 39 patients. The average passive metatarsophalangeal (MTP) dorsiflexion improved from 20.3 to 55.7 degrees (P = .001). The average MTP joint space improved from 2.2 to 2.3 degrees (P = .001). The radiographic measurements were unchanged, except anatomic angles related to phalangeal dorsiflexion. The average width of the bone wedge was 3.5 (range, 2.2-5.0) mm, and significant correlation was found with final AOFAS score (P = .006) and pain VAS (P = .001). There were 2 revisions for screw irritation. Phalangeal osteotomy was a reliable and reproducible treatment for moderate hallux rigidus in active patients, with substantial improvement in AOFAS score and MTP dorsiflexion and decreased pain. Level IV, prospective case series.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052703017

Download citation: RISBibTeXText

PMID: 25288332

DOI: 10.1177/1071100714552481


Related references

Hallux rigidus treated by dorsal-wedge osteotomy. Ugeskrift for Laeger 144(8): 552-553, 1982

Dorsal wedge osteotomy in the treatment of hallux rigidus. Journal of Foot and Ankle Surgery 37(1): 8, 1998

Dorsiflexory Phalangeal Osteotomy for Grade II Hallux Rigidus: Patient-Focused Outcomes at Eleven-Year Follow-Up. Journal of Foot and Ankle Surgery 58(1): 17-22, 2019

Dorsal wedge osteotomy of the proximal phalanx for hallux rigidus. Long-term results. Journal of Bone and Joint Surgery. British Volume 69(5): 835-837, 1987

Hallux rigidus: the long-term results of dorsal wedge osteotomy and arthrodesis in adults. Journal of Foot and Ankle Surgery 36(2): 136-40; Discussion 161, 1997

Phalangeal osteotomy versus first metatarsal decompression osteotomy for the surgical treatment of hallux rigidus: a prospective study of age-matched and condition-matched patients. Journal of Foot and Ankle Surgery 44(1): 2, 2005

Treatment of advanced stages of hallux rigidus with cheilectomy and phalangeal osteotomy. Journal of Bone and Joint Surgery. American Volume 95(7): 606-610, 2013

Outcomes after cheilectomy with phalangeal dorsiflexory osteotomy for hallux rigidus: a systematic review. Journal of Foot and Ankle Surgery 49(5): 479-487, 2010

Biplanar proximal phalanx closing wedge osteotomy for hallux rigidus. Foot and Ankle International 33(12): 1043-1050, 2012

Extension osteotomy for hallux rigidus with dorsal impingement. Foot 16(3): 125-129, 2006

Distal oblique first metatarsal osteotomy in grade 3 hallux rigidus: a long-term followup. Foot and Ankle International 29(7): 677-682, 2008

Arthrodesis of the first metatarso-phalangeal joint for hallux valgus and hallux rigidus. Guy's Hospital Reports 109: 174-178, 1960

Nonunion rate of first metatarsal-phalangeal joint arthrodesis for end-stage hallux rigidus with crossed titanium flexible intramedullary nails and dorsal static staple with immediate weight-bearing. Journal of Foot and Ankle Surgery 51(3): 308-311, 2012

A modified Austin/chevron osteotomy for treatment of hallux valgus and hallux rigidus. Journal of Orthopaedics and Traumatology 17(1): 89-93, 2016

Metallic resurfacing hemiarthroplasty of the first metatarsophalangeal joint combined with first metatarsal osteotomy for the treatment of hallux rigidus with hallux valgus in China. Chinese Medical Journal 127(11): 2186-2188, 2014