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Hallux Rigidus: Distal First Metatarsal Osteotomy/Hohmann Procedure

  • Amol Saxena

Abstract

Treatment of hallux rigidus with distal first metatarsal osteotomy has been advocated for many years.1-7 In clinical situations when there is a significantly long and elevated first metatarsal, along with dorsal hyperostosis, decreased hallux dorsiflexion, and pain, a surgical solution is to shorten and plantarflex the first metatarsal. This can be achieved by many techniques. These include distal, mid, and proximal first metatarsal osteotomies, Lapidus-type procedures and Cotton (dorsal opening-wedge) osteotomy of the first cuneiform.1,4 The results of these types of procedures are currently evidence Level IV. Randomized study of various procedures including comparing osteotomy for hallux rigidus to other techniques, such as arthrodesis, has not been performed. The results of reasonably sized case series in the short and medium term appear promising; there is only one study with more than 10 years average postsurgery follow-up.

Keywords

Loose Body Surgical Solution Metatarsal Osteotomy Hallux Rigidus Patient Activity Level 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Gonzalez J, Garrett P, Jordan J, Reilly C. The modified Hohmann osteotomy: an alternative joint salvage procedure for hallux rigidus. J Foot Ankle Surg. 2004;43(6):380-388.PubMedCrossRefGoogle Scholar
  2. 2.
    Derner R, Goss K, Postowski H, Parsley N. A plantarflexory-shortening osteotomy for hallux rigidus: a retrospective analysis. J Foot Ankle Surg. 2005;44(5):377-389.PubMedCrossRefGoogle Scholar
  3. 3.
    Ronconi P, Monachino P, Baleanu PM, Favilli G. Distal oblique osteotomy of the first metatarsal for the correction of hallux limitus and rigidus deformity. J Foot Ankle Surg. 2000;39(3):154-160.PubMedCrossRefGoogle Scholar
  4. 4.
    Oloff L, Jhala-Patel G. A retrospective analysis of joint salvage procedures for grades III and IV hallux rigidus. J Foot Ankle Surg. 2008;47(3):230-236.PubMedCrossRefGoogle Scholar
  5. 5.
    Malerba F, Milani R, Sartorelli E, Haddo O. Distal oblique first metatarsal osteotomy in grade 3 hallux rigidus: a long-term follow-up. Foot Ankle Int. 2008;29(7):677-682.PubMedCrossRefGoogle Scholar
  6. 6.
    Roukis T, Jacobs P, Dawson D, Erdmann B, Ringstrom J. A prospective comparison of clinical, radiographic, and intra-operative features of hallux rigidus: a short-term follow-up and analysis. J Foot Ankle Surg. 2002;41(3):158-165.PubMedCrossRefGoogle Scholar
  7. 7.
    Kilmartin T. Phalangeal osteotomy versus first metatarsal decompression osteotomy for the surgical treatment of hallux rigidus: a prospective study of age-matched and condition-matched patients. J Foot Ankle Surg. 2005;44(1):2-12.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.Department of Sports MedicinePAFMG-Palo Alto DivisionPalo AltoUSA

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