Extension osteotomy for hallux rigidus with dorsal impingement

Abstract We evaluated the long-term results of extension osteotomy of the proximal phalanx as a treatment for hallux rigidus. One hundred and eight extension osteotomies in 89 patients were reviewed clinical and radiologically, or by means of a postal questionnaire. Mean age was 58 years (range 19–81) and 74% were female. The length of follow-up was 25–164 months, with a mean of 82 (6.8 years). Seventy-six percent of the 108 procedures had a good or satisfactory result at review with 60% of the patients being completely pain-free. Seventy-four percent of the patients were satisfied with the operation. The average range of dorsiflexion at the first metatarsophalangeal joint at review was 41° (range 5–80) with 63% having greater than 30° of dorsiflexion. We found good results on medium to long-term follow-up for the treatment of hallux rigidus with dorsal impingement symptoms.