Therapeutic option for patients with severe hallux rigidus

Objective: Subclassify grade III of Hattrup and Johnson classification into two groups, according to the remaining percentage plantar articular cartilage, propose a treatment option other than arthrodesis for some these patients. Methods: Twenty-one patients with hallux rigidus were operated on between February 2015 January 2020. The radiographic Johnson’s was used, submitted frontal, lateral, oblique radiographs. Eventually, computed tomography (CT) performed. viable surface cartilage total joint determined: if there is up 50% preserved, indicating Weil osteotomy first metatarsal, associated wide dorsal cheilectomy (type 3A); less 50%, metatarsophalangeal indicated 3B). Patients metatarsal at least 5 mm shorter second frontal radiograph excluded from study. Results: A mean postoperative American Orthopaedic Foot & Ankle Society (AOFAS) score 91 obtained. To date, no patient has needed arthrodesis, all have increased range motion. Shortening central metatarsals not necessary as procedure due transfer metatarsalgia. Conclusion: Some joints classified can be treated an without needing arthrodesis. Level Evidence IV; Therapeutic Study; Case Series.