HALLUX RIGIDUS TREATMENT BY PERCUTANEOUS SURGERY

2009 
Introduction: We present 34 patients diagnosed with hallux rigidus treated by percutaneous surgery. We analyzed the surgical techniques used and the functional results achieved. Materials and methods: We retrospectively collected 34 patients (24 women). Patients were stratified by means of parametric x-rays (Hanft classification from 1 to 4). Treatment consisted in a double osteotomy, also known as Keller’s technique, using percutaneous procedures. The postoperative protocol consisted of walking, use of orthopedic footware, and early mobilization. Results: Mean age was 68.78 years and mean follow-up was 31.45 months. Mean time from first clinical visit to surgery was 4.38 years; most patients had received conservative treatment. The mean degree of hallux rigidus according to the standard classification was 2.5. The mean value of the metacarpophalangeal joint arc and interphalangeal joint arc was 40.35°and 52.14° respectively. Return to work activities was achieved in 90.9%. The mean value according on the VAS (visual analogue scale) (0–10) was 3.14. The mean value on the AOFAS scale was 62.57 (0–100). Conclusions: Percutaneous surgery is a satisfactory method for the treatment of hallux rigidus, enabling the patient to quickly return to work. This procedure avoids the use of osteosynthesis materials and minimizes the complications seen in open surgery.
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