Hallux Rigidus (Arthritis of the big toe)
Arthritis of the Big Toe will present with pain, deformity and stiffness (Rigidus). Initially a patient may notice pain on movement and a bony lump on the top of the toe. This lump is called an osteophyte and as it grows like a horn it will limit the movement in the toe. Eventually the joint becomes stiff as its cartilage is worn away.
Simple treatments – over the counter analgesia, stiff soled shoes to restrict movement at the joint.
- Cheilectomy : suitable for early stages. The joint is cleaned and the bony lumps (osteophytes) are shaved off.
- Steroid Injection and manipulation
- Fusion: for advanced stages. The remaining joint cartilage is removed and the deformity corrected. The two bones are then held together with metalwork until the join to become one bone. Once the bones have fused, there will be no movement at that joint and the pain will subside. You will still have movement in the surrounding joints and the foot.
Recovery – historically patients were placed in plaster and not allowed to walk on the foot. Now surgical recovery is much better, internal screws and plates are used to hold the bone, negating the need for a plaster and the patient can walk in a special sandal on the day of surgery. Initial bulky dressings are removed at two weeks, sandal to be removed at six weeks.