Hallux rigidus: etiology, biomechanics, and nonoperative treatment.

Hallux rigidus is a degenerative osteoarthritic process characterized by progressive loss of metatarsophalangeal joint range of motion and notable dorsal or periarticular osteophyte formation. Documented factors associated with hallux rigidus are a flat or chevron-shaped joint, hallux valgus interphalangeus, metatarsus adductus, bilaterality in persons with a positive family history, trauma history in unilateral cases, and female gender. Elevation of the first ray noted radiographically is thought to be a sign of worsening metatarsophalangeal joint function. Nonoperative care is aimed at improving comfort of the toe and foot with roomy shoes, selective joint injections, taping, and selective use of orthotics.