ABSTRACT
Hallux rigidus is defined as end-staged arthrosis of the first metatarsophalangeal joint. Although the literature supports arthrodesis as being the gold standard for the treatment of end-staged hallux rigidus, there are several other treatments available that can either prolong the life of the remaining joint or artificially mimic the original biomechanics by replacing a portion of or the entire joint with the added advantage of preserving joint mobility. There are several new and emerging joint preservative techniques that may delay or prevent the need for a joint-destructive procedure, such as arthrodesis or arthroplasty.
Subject(s)
Arthrodesis/methods , Arthroplasty/methods , Hallux Rigidus/surgery , Osteoarthritis/surgery , Osteotomy/methods , Prosthesis Design/methods , Adult , Aged , Female , Follow-Up Studies , Hallux Rigidus/pathology , Humans , Joint Prosthesis , Male , Metatarsophalangeal Joint/diagnostic imaging , Metatarsophalangeal Joint/surgery , Middle Aged , Osteoarthritis/diagnostic imaging , Osteoarthritis/physiopathology , Pain Measurement , Patient Satisfaction , Prosthesis Implantation/methods , Radiography , Range of Motion, Articular/physiology , Risk Assessment , Severity of Illness Index , Treatment OutcomeABSTRACT
This article describes a joint-preserving and joint-restoring procedure for the management of hallux limitus and hallux rigidus. The procedure uses a minirail external fixator to obtain distraction with or without arthrotomy of the first metatarsophalangeal joint. This procedure aims to restore joint function through elimination of the pathologic forces involved in hallux limitus and hallux rigidus. Both intrinsic and extrinsic muscular imbalances are reduced. Follow-up of 133 patients treated in this manner since 1997 demonstrates excellent long-term results.
Subject(s)
Hallux Limitus/surgery , Metatarsophalangeal Joint/surgery , Arthrodesis/instrumentation , Arthrodesis/methods , External Fixators , Hallux Limitus/physiopathology , Humans , Metatarsophalangeal Joint/physiopathology , Reproducibility of ResultsABSTRACT
The purpose of this article is to describe a new suturing technique that everts the skin and is a modification the horizontal mattress suture called the Rousso stitch. The technique is described step by step, along with reference pictures. The Rousso stitch technique was developed based on the well-documented theory behind everting the edges of thicker skin on closure of surgical incisions to allow for ideal coaptation and minimal scar formation. It is an easy technique to learn and appears to be a good time-saving option for the surgeon to use for the same applications of the typical horizontal mattress suture.
