Hallux Rigidus

The big toe bone (hallux) forms a joint with the long metatarsal bone in the foot . Hallux rigidus is arthritis of this joint, which slowly decreases the toe’s movement. A bony bump (an osteophyte or dorsal bunion) may develop on top of the joint – this is your body's natural response to the worn joint. The bump may rub on your shoes.

Osteoarthritis is usually the result of some previous injury, such as breaking the toe. It can also be the result of overuse – repetitive bending and stooping, for example. It tends to affect people over 50, but can occur in those as young as 20.

How does it feel

Pain in and around your big toe joint can be present all the time, or just when you walk. You will also feel pain when you pull your big toe up towards you. The big toe may become so stiff that you cannot pull your big toe up at all.

Diagnosis

The surgeon will examine your feet and manipulate the big toe to determine its range of motion. X-rays will determine how much arthritis is present and evaluate any bone spurs or other abnormalities that may have formed.

Surgery

Debridement: During arthroscopic surgery, the area around the diseased bone will be cleaned and any bone spurs and deformities will be removed.

Cheilectomy: This is a minor operation to remove the bony bump (an osteophyte or dorsal bunion) which develops as a result of the body’s attempt to heal the arthritis. This bony bump or spur is carefully burred away to restore the bone to its normal shape. This would normally resolve some 60% to 70% of the pain and stiffness.

Fusion: The two joint surfaces which generated the pain are removed, and the cut edges placed next to each other in a position that allows the fused joint to rock, rather than flex as it normally does.

After debridement and cheilectomy, you can be walking almost immediately. With fusion, however, it may be four weeks before you can put weight on the foot.

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