Hallux Rigidus (Stiff Big Toe)

Indication

This is the term for arthritis of the metatarso-phalangeal joint of the great toe. Such a joint may also have a valgus deformity, and the indications for surgery are the same as for Hallux Valgus i.e. pain and difficulty with shoe wear. The treatment however is somewhat different. Non-operative treatment would employ the use of orthoses and the use of cortico-steroid injections into the joint.

At long last I am pain free and I can walk much better – from Y.P

Operation

Where the symptoms dictate, surgical intervention can be used with fusion of the metatarso-phalangeal (MTP) joint. This can be performed under regional or general anaesthetic and the two surfaces of the MTP joint are pared down of any articular cartilage and held together with a cross articular fixation and a plaster cast for three weeks. The cast is removed after three weeks and as with hallux valgus, the state of the union is assessed radiologically and in most cases, the foot is left free of plaster and physiotherapy commenced if required. This condition is not uncommon in sporting individuals and rigorous sporting activities, which load the MTP joint need to be avoided for some three months following surgery.