A J Maher1, S A Metcalfe. 1. Department of Podiatric Surgery, Solihull Care Trust, Chelmsley Wood Primary Care Centre, Crabtree Drive, Chelmsley Wood, Birmingham B37 5BU, UK. anthony maher79@yahoo.co.uk
Abstract
BACKGROUND: Arthrodesis of the first MTP joint is an accepted and long established joint destructive procedure for the management of hallux rigidus. OBJECTIVES: This paper presents the results of 29 consecutive first MTP joint arthrodesis procedures for the treatment of hallux rigidus. METHOD: The outcomes of 29 (18 female and 11 male) consecutive arthrodesis procedures were analysed with the Foot Health Status Questionnaire (FHSQ), minimal important difference scores, and a patient satisfaction questionnaire. RESULTS: FHSQ foot pain scores improved for 27 (93%) patients; foot function improved for 23 (79%) patients; shoe scores improved for 18 (62%) patients; foot health improved for 20 (68%) patients; general health improved for 12 (41%) patients; physical activity improved for 21 (72%) patients; social capacity improved for 21 (21%) patients; vigour improved for 15 (51%) patients. FHSQ minimal important difference scores were achieved for foot pain in 25 patients (86%); foot function in 17 patients (58%); and general foot health in 19 (65%) patients. Analysis with the matched pairs Wilcoxon rank sum test (p<0.05) revealed statistically significant improvement in all FHSQ domains. Female patients appeared to fare better than male patients in all FHSQ categories other than general health and vigour. CONCLUSION: Arthrodesis of the first MTP joint can reliably reduce pain relating to hallux rigidus and can improve foot function and allow a return to physical activity.
BACKGROUND: Arthrodesis of the first MTP joint is an accepted and long established joint destructive procedure for the management of hallux rigidus. OBJECTIVES: This paper presents the results of 29 consecutive first MTPjoint arthrodesis procedures for the treatment of hallux rigidus. METHOD: The outcomes of 29 (18 female and 11 male) consecutive arthrodesis procedures were analysed with the Foot Health Status Questionnaire (FHSQ), minimal important difference scores, and a patient satisfaction questionnaire. RESULTS:FHSQ foot pain scores improved for 27 (93%) patients; foot function improved for 23 (79%) patients; shoe scores improved for 18 (62%) patients; foot health improved for 20 (68%) patients; general health improved for 12 (41%) patients; physical activity improved for 21 (72%) patients; social capacity improved for 21 (21%) patients; vigour improved for 15 (51%) patients. FHSQ minimal important difference scores were achieved for foot pain in 25 patients (86%); foot function in 17 patients (58%); and general foot health in 19 (65%) patients. Analysis with the matched pairs Wilcoxon rank sum test (p<0.05) revealed statistically significant improvement in all FHSQ domains. Female patients appeared to fare better than male patients in all FHSQ categories other than general health and vigour. CONCLUSION: Arthrodesis of the first MTP joint can reliably reduce pain relating to hallux rigidus and can improve foot function and allow a return to physical activity.