Hallux limitus is among the most common
arthritides of the foot and ankle, with increasing incidence in the aging population. Despite its prevalence and disease burden, treatment of the condition remains poorly understood. Many patients will fail initial
conservative management, whereas controversy exists surrounding indications for and outcomes of surgery. The present study sought to examine the impact of a novel forefoot
orthosis on foot function,
pain, and plantar pressure distributions in patients with symptomatic
hallux limitus. Nineteen adult patients completed a questionnaire consisting of the 23-item Foot Function Index and a 10-point visual analogue scale measuring
pain. Standing pedobarographic maps were generated using a foot scanning system. Participants were instructed to wear the
orthosis in athletic shoes for 4 weeks. Eighteen participants (94.7%) experienced improvements in foot function and
pain, with 12 (63.2%) reporting complete resolution of
pain at the end of the 4-week trial. Mean Foot Function Index scores improved significantly from 43.0% at baseline to 11.0% with the
orthosis (p < .001). Similarly, mean visual analogue scale
pain scores decreased significantly from 4.87 to 1.18 (p < .001). Pedobarographic analysis while wearing the
orthosis demonstrated increased ability of participants to bear weight on the arthritic hallux metatarsophalangeal joint and restoration of physiologic stance. Compared to existing products, the device was well tolerated and did not require footwear modifications or impede normal gait. Overall, the
orthosis offers an appealing
solution to patients dissatisfied with existing treatment options as well as those who may be averse to or ineligible for surgery.