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Joint fusion for hallux rigidus and hallux valgus improved function
Van Doeselaar DJ. Foot Ankle Int. 2010;31(8):670-675.
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Function improved after fusion of the first metatarsophalangeal joint for hallux rigidus and hallux valgus, according to Dutch researchers.
From 2002 to 2005, 62 consecutive patients underwent crossed screw fusion of the first metatarsophalangeal joint without concomitant surgery of the same or contralateral foot. No patients had previous surgery of the same foot. Twenty-seven patients had hallux rigidus, and 35 patients had hallux valgus.
Dimitri J. van Doeselaar, MD, and colleagues at Sint Maartenskliniek, Nijmegen, The Netherlands measured foot function preoperatively and postoperatively with the Dutch Foot Function Index. They measured hallux valgus and dorsiflexion angles on standing radiographs preoperatively and at follow-up.
The postoperative median hallux valgus angle was 14° (range, -2° to 33°); the median dorsiflexion angle was 23° (range, 7° to 45°). The median Dutch Foot Function Index score improved from 38 preoperatively to 8 postoperatively (P<.001); scores were the same for the hallux valgus and hallux rigidus groups. Researchers found no link between postoperative foot function, dorsiflexion angles and hallux valgus angles.
According to the validated Dutch Foot Function Index, fusing the first metatarsophalangeal joint in hallux rigidus or valgus improved function, the authors wrote. “There was no significant correlation between foot function and hallux position. This could be due to the fact that the desired position of the hallux was most often achieved.”