Hallux rigidus: Joint preserving alternatives to arthrodesis- a review of the literature

作     者：Hans Polzer Sigmund Polzer Mareen Brumann Wolf Mutschler Markus Regauer 

作者机构：Munich University Hospital Foot and Ankle Surgery Department of Trauma Surgery-Campus Innenstadt Department of Hand Ellbow and Footsurgery ATOS Clinic Heidelberg 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2014年第5卷第1期

页      面：6-13页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Hallux rigidus Osteoarthritis First metatarsophalangeal joint Joint preserving Operative treatment Osteotomy 

摘      要：Hallux rigidus describes the osteoarthritis of the firstmetatarsophalangeal joint. It was first mentioned in 1887. Since then a multitude of terms have been introduced referring to the same disease. The main complaints are pain especially during movement and a limited range of motion. Radiographically the typical signs of osteoarthritis can be observed starting at the dorsal portion of the joint. Numerous classifications make the comparison of the different studies difficult. If non-operative treatment fails to resolve the symptoms operative treatment is indicated. The most studied procedure with reproducible results is the arthrodesis. Nevertheless, many patients refuse this treatment option, favouring a procedure preserving motion. Different motion preserving and joint sacrificing operations such as arthroplasty are available. In this review we focus on motion and joint preserving procedures. Numer-ous joint preserving osteotomies have been described. Most of them try to relocate the viable plantar cartilage more dorsally, to decompress the joint and to increase dorsiflexion of the first metatarsal bone. Multiple studies are available investigating these procedures. Most of them suffer from low quality, short follow up and small patient numbers. Consequently the grade of recommendation is low. Nonetheless, joint preserving procedures are appealing because if they fail to relief the symptoms an arthrodesis or arthroplasty can still be performed thereafter.