Cheilectomy With Decompression Osteotomy for Treatment of Hallux Limitus and Rigidus: A Retrospective Study With 5-Year Outcomes.

Abstract

We examined outcomes following metatarsophalangeal joint cheilectomy with decompression osteotomy to evaluate the efficacy of this technique for treatment of hallux limitus/rigidus. At a minimum follow-up of 5 years, we identified 94 patients who fit the inclusion criteria. Chart review was performed to obtain range of motion (ROM) of the first metatarsophalangeal joint (MTPJ) preoperatively and at 6 weeks, 6 months, and 5 years postoperatively. Additionally, time to traditional shoe gear return, need for revision arthrodesis, radiographic findings, and postoperative visual analog scale (VAS) pain scores were reviewed. Statistical analysis was conducted by 1-way analysis of variance with post-hoc analysis and independent sample t-test. At an average follow-up of 6.3 ± 0.9 years, 42.3% (33/78) of females and 25.0% (4/16) of males reported limited ROM of the first MTPJ with 5 patients requiring first MTPJ arthrodesis. MTPJ ROM improved on average from 11.0° to 36.3° by 5-year minimum follow-up after surgery (p < .001). Analysis of variance revealed a significant difference of the preoperative ROM when compared to all postoperative time points (F[3,368] = 69.4, p < .001). Mean postoperative VAS pain scores after decompression osteotomy of the 5 patients who required MTPJ fusion were higher when compared to the rest of the patient cohort at final follow-up (7.4 ± 0.6 vs 1.5 ± 1.3; p < .001). Cheilectomy with decompression osteotomy for treatment of hallux limitus/rigidus leads to satisfactory long-term outcomes.

• Authors: John Shields, Neil Gambhir, Matthew Alben, Alina Kogan, Paul Greenberg, Rick Delmonte
• Journal: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons (J Foot Ankle Surg) 2023 Mar-Apr Vol. 62 Issue 2 Pg. 282-285 ISSN: 1542-2224 [Electronic] United States
• PMID: 36117052 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Male
• Female
• Humans
• Retrospective Studies
• Hallux Limitus
• Hallux Rigidus (surgery)
• Osteotomy (methods)
• Metatarsophalangeal Joint (surgery)
• Decompression
• Pain
• Follow-Up Studies
• Treatment Outcome