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Treatment of Advanced Stages of Hallux Rigidus with Cheilectomy and Proximal Phalangeal OsteotomySurgical Technique
Andrew J. Elliott, MD1; Stephanie C. Sayres, BS1; Martin J. O’Malley, MD1
1 420 East 72nd Street, Suite 1B, New York, NY 10021. E-mail address for A.J. Elliott: ElliottA@hss.edu. E-mail address for S.C. Sayres: SayresS@nyfootandanklemd.com. E-mail address for M.J. O’Malley: OmalleyM@hss.edu
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Based on an original article: J Bone Joint Surg Am. 2013 Apr 3;95(7):606-10.



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2013 Jul 24;3(3):e14 1-7. doi: 10.2106/JBJS.ST.M.00026
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Extract

Overview
Introduction

We believe that a combination of cheilectomy and proximal phalangeal osteotomy can be used successfully (with an 85% satisfaction rate1) in patients with advanced hallux rigidus, including those in whom it is classified as Hattrup and Johnson2 Grade III or as Coughlin and Shurnas3 Grade III or IV (extensive degeneration of the joint involving >50% of the articular surface).

Step 1: Surgical Approach

Begin with a dorsal approach to the first metatarsophalangeal joint and phalanx.

Step 2: Cheilectomy

Remove osteophytes and the dorsal third of the first metatarsal head.

Step 3: Proximal Phalangeal Osteotomy

Perform a 3-mm dorsal-based closing-wedge osteotomy of the proximal phalanx.

Step 4: Closure and Postoperative Protocol

Close the metatarsophalangeal joint capsule and skin.

Results

We reviewed the results in eighty-one patients with advanced hallux rigidus who were treated with a combination of cheilectomy and proximal phalangeal osteotomy.

What to Watch For

Indications

Contraindications

Pitfalls & Challenges

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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