Current Concepts Review: Hallux Rigidus

Yee, Gilbert; Lau, Johnny

doi:10.3113/fai.2008.0637

Cited by 165 publications

(108 citation statements)

References 75 publications

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“…Puede disminuir significativamente la longitud del paso, reducir la flexión plantar de tobillo y la potencia en el despegue de antepié 19 . Una de las complicaciones más frecuentemente encontradas en la artrodesis es la falta de unión 20 .…”

Section: Antecedentes Y Estado Actual Del Temaunclassified

Meta-analysis of First Metatarsophalangeal Joint Implant Arthroplasty

Cook

Rosenblum

et al. 2009

The Journal of Foot and Ankle Surgery

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Resumen. El Hallux Rígidus (HR) afecta a la primera articulación metatarsofalángica (AMTF) entre el 35% y el 60% de la población mayor de 65 años y existen múltiples vías de tratamiento. En función del estadio radiológico en el que se encuentre la deformidad, se determina el procedimiento a realizar; en los estadios iniciales se realiza las técnicas de queilectomia y osteotomías correctoras mientras que en las clasificaciones más avanzadas, el cirujano escoge entre las técnicas consideradas destructivas como la artrodesis y la artroplastia. Este trabajo de fin de grado tiene como objetivo centrarse en las técnicas destructivas en 1 AMTF, para aclarar cuál de los procedimientos genera mejores resultados según una serie de parámetros; los resultados de la escala American Orthopaedic Foot and Ankle Society-Hallux Metatarsophalangeal Interphalangeal scale (AOFAS), rango de movimiento (ROM) de la 1ºAMTF, clasificación radiológica. En cuanto a la técnica de artroplastias por implante, este artículo nos ofrece información sobre el material y diseño qué genera mejores resultados relacionándolo con las características del paciente como la edad, la presencia de patologías inflamatorias articulares, la viabilidad y la durabilidad del implante. La conclusión obtenida en esta revisión es que los valores obtenidos en la artrodesis según AOFAS disminuyen debido a la pérdida de movilidad, pero ambas técnicas presentan valores similares de efectividad y concluye con la decisión de que la técnica a utilizar se determina teniendo en cuenta varios factores y características del paciente. Palabras clave: Hallux rígidus; Hallux rígidus y tratamientos quirúrgicos; Hallux rígidus y Artrodesis; Hallux rígidus y Artroplastia; Hallux rígidus (Artroplastia y Artrodesis).[en] Hallux rigidus: Arthroplasty or arthrodesis. What technique produces better results?Abstract. Hallux rígidus (HR) affects the first metatarsophalangeal joint (MTPJ) between 35% and 60% of the population over 65 years and there are multiple ways of treatment. Depending on the radiological stage where you find the deformity determines the procedure to be performed; in the early stages cheilectomy techniques and corrective osteotomy is performed while the more advanced ratings, the surgeon chooses destructive techniques considered as arthrodesis and arthroplasty. This final of degree project aims to focus on 1 MTPJ destructive techniques to clarify which of the procedures generates better results by a number of parameters; outcomes of the American Orthopaedic Foot scale and Ankle Society Hallux metatarsophalangeal Interphalangeal-scale (AOFAS), range of motion (ROM) of the 1ºAMTF, radiological classification. As for the implant arthroplasty technique, this article offers information on material and design that generates better relating to patient characteristics such as age, inflammatory joint diseases, viability and durability of the implant results. The conclusion from this review is that the values obtained in the arthrodesis according AOFAS decrease due to loss of mob...

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Section: Antecedentes Y Estado Actual Del Temaunclassified

Meta-analysis of First Metatarsophalangeal Joint Implant Arthroplasty

Cook

Rosenblum

et al. 2009

The Journal of Foot and Ankle Surgery

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“…İleri evre halluks rigidus tedavisinde artrodez sıklıkla tercih edilen bir seçenektir ve başarı oranları %90-%100 arasında değişiklik göstermektedir (11)(12)(13)(14). Coughlin ve Shurnas (5) yaklaşık altı yıl takip ettikleri artrodez hastalarında %94 kaynama oranı ile birlikte iyi ve mükemmel sonuç elde etmişlerdir.…”

Section: Discussionunclassified

“…Bu zamana kadar vida, eksternal fiksatör, steinman pini, K teli, tel dikişler, emilebilen dikişler, plak veya U çivisi gibi çeşitli materyaller ile artrodez bildirilmiştir (4)(5)(6)(7)(8)(9). Günümüzde plak-vida kombinasyonu, iki çapraz vida ve daha az sıklıkla tek vida sıklıkla tercih edilen tespit seçenekleridir ve birbirlerine üstünlüklerini gösteren çeşitli çalışmalar mevcuttur (5)(6)(7)(8)(9)(10)(11).…”

Section: Introductionunclassified

İleri Evre Halluks Rigidus Tedavisinde Tek Kortikal Vida ile Primer Artrodez

Yavuz¹,

Gül²,

Özer³

et al. 2014

Haseki

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ÖzetAmaç: Bu çalışmanın amacı halluks rigidus nedeniyle artrodez yapılırken tek kortikal vida kullanılmasının klinik ve radyolojik açıdan yeterliliğini değerlendirmektir.Yöntemler: İleri evre halluks rigidus tanısıyla tek kortikal vida kullanılarak artrodez uygulanan 18 hasta (16 kadın, 2 erkek) geriye dönük olarak değerlendirildi. Hastaların yaş ortalaması 58,1 yıl (dağılım 44-69 yıl) idi. Caughlin ve Shurnas'ın evreleme sistemine göre 5 ayak evre 3 ve 13 ayak evre 4 olarak değerlendirildi. Klinik değerlendirme American Orthopaedic Foot and Ankle Society (AOFAS) metatarsofalangeal-interfalengeal skalası ile yapıldı. Son takip grafileri üzerinden halluks valgus açısı, yere göre birinci parmak dorsifleksiyon açısı ölçüldü. Bulgular: Ortalama izlem süresi 32,4 ay (dağılım 14-69 ay) idi. Bir hastada radyolojik kaynamama mevcuttu. Hastaların preoperatif AOFAS skoru ortalama 56,1 (dağılım 38-72) idi. Hastaların son kontrolünde ortalama AOFAS skoru 81,1 bulundu. AOFAS skoruna göre iki hasta (% 11,1) orta, 11 hasta (% 61,1) iyi, beş hastada (% 27,8) Abs tractAim: The aim of this study was to evaluate the clinical and radiological results in patients with severe hallux rigidus who underwent arthrodesis using single cortical screw. Methods:We retrospectively evaluated 18 patients (16 females, 2 males) who underwent arthrodesis for severe hallux rigidus using single cortical screw. The mean age of the patients was 58.1 (range: 44-69) years. According to the Coughlin and Shurnas classification, 5 feet were rated as stage 3 and 13 feet were stage 4. 3 of the stage 3 patients had cheilectomy previously. The American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating scale for the metatarsophalangeal -interphalangeal joints was used for clinical evaluation. Hallux valgus angles and hallux dorsiflexion angles were measured on X-rays. Results:The mean follow-up period was 32.4 (range: 15-69) months. Radiological signs of non-union was found in one patient. The mean preoperative AOFAS score was 56.1 (range: 38-72). The mean final follow-up AOFAS score was found to be 81.1. Moderate results in 2 patients (11.1%), good results in 11 patients (61.1%) and excellent results in 5 patients (27.8%) were obtained. When the last X-rays were evaluated, 15.1° (7-24) valgus at the metatarsophalangeal joint and 11.9° (8-18) extension (to the floor) at the metatarsophalangeal joint were detected. Late surgical wound healing was observed in one patient. The screws were removed due to irritation in 8 (44%) patients. Conclusion:We assume that in the treatment of severe hallux rigidus, arthrodesis using a single cortical screw may be considered as a favorable surgical technique with its high union rates and increased functional results. (The Me di cal Bul le tin of Ha se ki 2014; 52:158-63)

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“…The percutaneous MTP1 fusion is a simple and quick procedure which can achieve functional results comparable to those obtained with open MTP1 fusion with more than 90% of patients satisfied [Womack [7], Goucher [13], Coughlin [19], Flavin [20], Brodsky [21], Yee [22].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous First Metatarso-Phalangeal Joint Fusion

Bauer

2010

Minimally Invasive Surgery of the Foot and Ankle

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Abstract:The first metatarsophalangeal (MTP1) joint fusion is a very useful procedure in forefoot surgery and is still the gold standard for the treatment of severe and painful hallux rigidus. Normal walking and running are possible after MTP1 fusion, the first ray mobility being essentially in the interphalangeal (IP) joint with a compensatory hypermobility in dorsal flexion. Percutaneous MTP1 fusion is a simple procedure providing comparable results to fusions performed with open techniques. Postoperative cares are simplified with an immediate full weight bearing on rigid flat shoes and quick return to normal walking. Bone preparation is an important step and requires an experience in percutaneous forefoot surgery. Arthrodesis positioning and fixation with this percutaneous procedure are simple with possibility of clinical and radiological control. The indications for percutaneous MTP1 fusion are very large and only severe bone loss or osteoporosis represent the limits for this technique.

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Current Concepts Review: Hallux Rigidus

Cited by 165 publications

References 75 publications

Meta-analysis of First Metatarsophalangeal Joint Implant Arthroplasty

Meta-analysis of First Metatarsophalangeal Joint Implant Arthroplasty

İleri Evre Halluks Rigidus Tedavisinde Tek Kortikal Vida ile Primer Artrodez

Percutaneous First Metatarso-Phalangeal Joint Fusion

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