Management of high-grade hallux rigidus: a narrative review of the literature


Hallux rigidus is a disease characterized by an osteoarthritic degeneration of the first metatarsophalangeal joint. Aetiology of hallux rigidus is not clear in the literature. History of trauma is considered one of the most common causes of unilateral hallux rigidus. Also, repetitive microtraumas or inflammatory and metabolic causes such as gout, rheumatoid arthritis and seronegative arthropathy can cause degeneration of the joint. The aim of this literature narrative overview is to summarize and expose the great amount of management concepts and information, including the well-codified main operative procedures to treat of hallux rigidus. This may provide current information for med-school students, researchers and physicians. A comprehensive literature search using PubMed database has been performed. The management for hallux rigidus can involve a variety of therapeutic interventions, conservative or operative. High-grade hallux rigidus represents a complex disease characterized by several clinical and pathological findings, and to achieve optimal results, surgical treatment should be chosen between several surgical techniques depending on the degree of arthritis and other different clinical conditions.

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Authors would like to thank Dr. Maria Pia Cumani from Scuola di Disegno Anatomico, IRCCS Rizzoli Orthopaedic Institute (Bologna, Italy), for artwork and figures.

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Correspondence to S. Caravelli.

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Massimi, S., Caravelli, S., Fuiano, M. et al. Management of high-grade hallux rigidus: a narrative review of the literature. Musculoskelet Surg 104, 237–243 (2020).

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  • Hallux rigidus
  • Osteoarthritis
  • Surgical
  • Review
  • Keller
  • Arthroplasty
  • Fusion