Hallux rigidus is arthritis/stiffness of the big toe joint. This joint is important in walking and when stiffened, can make walking painful and difficult. Wear and tear and injury to the cartilage surrounding the big toe joint can cause bone overgrowth, which causes stiffening. If nonsurgical treatment is insufficient, hallux rigidus surgery can be treated by a cheilectomy, where an incision is made on the top of the foot and bone spurs and a portion of the foot bone are removed, allowing more room for the toe to bend. This is performed under local anaesthesia. In addition, for more severe deformity and loss of function of the big toe joint, a fusion of the joint or joint arthroplasty can be performed.
Who is a candidate?
Candidates for hallux rigidus surgery typically have failed to respond to nonsurgical treatment and/or have significant arthritis or deformity of the big toe joint. Typically, a physical examination will help determine if ankle ligament reconstruction is the best option for relieving ankle instability.
Who is not a candidate?
Candidates who have not yet exhausted nonsurgical treatment options are not good candidates for hallux rigidus repair.
Like other surgeries, hallux rigidus repair requires a pre-operative assessment of your toes and overall physical health to ensure that surgery is the best treatment course. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery procedures such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You will likely be asked to stop eating or drinking the night before the surgery.
Immediately after the procedure, you will likely feel some pain. You may be given prescription pain relievers for discomfort. You may experience swelling for the longer term, but these symptoms should subside with time. For cheilectomy, most surgeons will recommend wearing a hard-soled sandal and slowly increasing weight-bearing for two weeks, before returning to normal footwear. For more invasive procedures, the foot may be in a cast for 6-8 weeks, and limiting weight-bearing may only be possible after this.
As with any surgery, there are risks of complications related to scarring, infection or adverse reactions to anesthesia. Risks specific to hallux rigidus repair include failure to relieve symptoms and requiring revisional surgery, especially if arthritis continues to increase in severity.
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