Gait changes following cheilectomy for hallux rigidus

Hallux Rigidus is a condition in which the movement of the big toe or hallux joint of the feet are rigid and is commonly associated with osteoarthritis. The great toe joint of the foot is actually quite a crucial joint in the body as it must flex so the leg can move ahead over the feet when walking. If anything blocks the motion at that joint, then moving forward is going to be a lot harder and force is going to be placed on other joints that have to move more as that joint is not flexing adequately. This can bring about pain in the big toe or hallux joint along with other joints. In addition, it will cause an unusual wear pattern on the shoes.

The primary cause of hallux rigidus is generally a prior injury to the joint. With time this sets up a process of abnormal use that leads to further damage and osteoarthritis to the joint. Gradually the restricted motion of the joint is even further restricted and the joint becomes rigid with no movement possible.

 

The simplest way to manage a hallux rigidus is appropriate management of the original injury with good rehabilitation and the use of exercises to avoid or slow down the developments of the osteoarthritis. When the joint is painful, then medications and injections into the joint can be used for the pain. The use of a stiffer sole shoe is frequently beneficial as this reduces the demand on the joint to bend.

Some shoes can also have a rocker added to them, so that you move over the rocker and don't need to use the joint as much. If these conservative measures aren't helpful, then the next step is surgical. There are several options here. The easiest, if indicated, is to just cut off some bone of the top of the joint to allow to bend more. If that's not possible, then the joint can be surgically fused to prevent it moving. This kind of fusion addresses the symptoms from the osteoarthritis because the joint can't flex.