ABSTRACT
Cheilectomy, as applied to hallux limitus/rigidus, is described as resection of the dorsal osteophytes and lateral/medial margins of the first metatarsal, as well as the dorsal lip of the base of the proximal phalanx. Forty-seven patients underwent unilateral cheilectomy, with an average follow-up of 3.5 years, and an average patient age of 52 years. Dependent upon the progressive nature of the disease, the results varied with the most beneficial results in the early stages of hallux limitus/hallux rigidus, which include symptoms, re-operation, and range of motion. The indications for cheilectomy are hallux limitus/rigidus in grade I or grade II without sesamoid disease. Late grade II or grade III with sesamoid disease and degenerative joint disease are also described in terms of surgical treatment. The advantages of cheilectomy include early range of motion and rapid decrease in clinical symptoms; cheilectomy obviates the need for healing at an osteotomy site. The disadvantages include not addressing the underlying etiology, potential joint destruction, slippage, or pseudo-articulation at the joint's end range of dorsiflexion. It is not indicated in later stages of the disease.
Subject(s)
Hallux/surgery , Metatarsal Bones/surgery , Metatarsophalangeal Joint/surgery , Adult , Aged , Female , Follow-Up Studies , Foot Deformities, Acquired/diagnostic imaging , Foot Deformities, Acquired/physiopathology , Foot Deformities, Acquired/surgery , Humans , Male , Metatarsal Bones/diagnostic imaging , Metatarsophalangeal Joint/diagnostic imaging , Metatarsophalangeal Joint/physiopathology , Middle Aged , Orthopedics/methods , Pain, Postoperative/epidemiology , Radiography , Range of Motion, Articular , Treatment OutcomeABSTRACT
One hundred fifteen feet that underwent a Wilson (lateral, transpositional, shortening) osteotomy for the correction of hallux valgus between 1979 and 1989 were retrospectively reviewed. All osteotomies were stabilized either with a single cortical or cancellous screw, or with crossed Kirschner wires. The Wilson procedure is not technically difficult and can allow for tri-plane correction. Of the 115 feet on which this surgical procedure was performed, 92 (80%) were graded in long-term postoperative recovery as excellent or good. Only one complication of hallux varus occurred, which required additional surgery. Survey of the results of the 10-year experience in utilization of this operative procedure has shown a high patient satisfaction with minimum of postoperative complications and a low failure rate.
Subject(s)
Hallux Valgus/surgery , Internal Fixators , Osteotomy/methods , Follow-Up Studies , Hallux Valgus/diagnostic imaging , Humans , Osteotomy/instrumentation , Radiography , Retrospective StudiesABSTRACT
Sudeck's atrophy, initiated by local irritation, proceeds from a mild form of neurovascular and osseous changes to a stage of increasing or intractable pain and trophic changes. Differential diagnosis is important as a number of conditions may produce a similar clinical picture. At any stage, the disease may improve spontaneously or from therapy, or it may result in varying degrees of permanent disability.
