Hallux Rigidus Surgery Perth

Frozen toe, or hallux rigidus or its less severe sibling hallux limitus, is a condition characterised by stiffness and loss of motion in the 1^st toe (also known as the hallux, great toe, or big toe). It is a form of osteoarthritis that is manifests as changes in the large joint at the base of the 1^st toe (metatarsal‑phalangeal joint) and can include bony spurring and even loose bodies that impede joint movement and erode cartilage. It can run in families, often presents in both feet and is more common in females.¹ It regularly occurs in people over 50 with flatter feet and tightness in their calves causing limited ankle movement.²

 

Significant pain can be associated with the limited movement of the 1^st toe, but the limitation can also simply affect function in everyday and sporting activities. Hallux rigidus can be differentiated from a classic 1^st toe bunion because it usually does not present with deviation of the 1^st toe or a prominent bump at the inner aspect of the large joint at the base of the 1^st toe.

 

Hallux rigidus is a progressive condition which usually deteriorates over time. It can be classified from mild to severe, depending on structural changes that occur in the 1^st metatarsal-phalangeal joint.

 

Because hallux rigidus involves a functional limitation it can lead to injuries and conditions in other parts of the foot, including the lesser toes, and especially the 2^nd toe. If you have significant pain or are finding activities difficult treatment for hallux rigidus should be considered.

Hallux rigidus can be treated conservatively or with surgical correction. It is important to consider conservative treatment before pursuing surgical options.

 

Dr Pocklington is both a Podiatric Surgeon (foot and ankle specialist surgeon) and trained podiatrists with extensive understanding of the form and function of the foot before and after surgery. This includes consideration of conservative as well as surgical intervention and the overall function (biomechanics of your foot).

 

Conservative treatment of hallux rigidus is restricted to accommodation and offloading of the 1^st metatarsal-phalangeal joint, via intrinsic muscle strengthening, joint manipulation and stretching, taping and strapping, and custom orthoses. The goal of conservative treatment is to return function to the 1^st toe and foot while minimising pain and compensatory pathologies in other areas.

 

While conservative treatment can help, it does not reverse changes in the 1^st metatarsal-phalangeal joint. Surgical intervention is often needed to address the structural damage that occurs in the 1^st metatarsal-phalangeal joint in moderate to severe cases of hallux rigidus.

If conservative measures are not able to alleviate your discomfort, if there is significant pain or the restrictions in your 1^st toe’s movement are interfering with you being active surgical intervention should be considered.

 

The goal of hallux rigidus surgery is to restore function to the foot. If possible, this is achieved through remodelling and repair of the joint at the metatarsal head and base of the proximal phalanx of the 1^st toe. Generally, hallux rigidus surgery involves one of three options depending on severity and nature of the presentation:

1. Cheilectomy, surgical remodelling of the joint
2. Joint repair via arthroplasty, including the use of synthetic joint implants like the CARTIVA® synthetic cartilage.
3. Join fusion via arthrodesis

 

The key result is reduction or resolution of pain and a healthy return to normal activities and footwear. As a Podiatric Surgeon, Dr Pocklington is a foot and ankle specialist trained extensively in procedures used to treat hallux rigidus and can assist you in deciding whether surgery is right for you.

 

The recovery period for each procedure is different, but each is performed as a day surgery allowing you to immediately weight bear on your foot in a stiff sole surgical shoe. Sometimes people stay overnight at a private hospital and return home the following day.

 

For more information on each type of procedure please visit the following links:

• Cheilectomy
• Arthroplasty, CARTIVA® synthetic cartilage.
• Join fusion

 

Please book online to speak with Dr Pocklington (Podiatric Surgeon) about hallux rigidus correction.