They include arthrodesis (fusion of the joint), arthroplasty, cheilectomy (trimming of the joint), Keller procedure (simple excision of the joint), osteotomy, and plantar release.
Many surgical procedures have been described for the treatment of congenital and acquired conditions of the big toe. Conservative treatments include exercise, physiotherapy, supportive shoes worn alone or worn with soft/semi-rigid orthoses, non-steroidal anti-inflammatory drugs, and steroid injections. Although the literature addressing treatments of conditions that affect the hallux often focuses on surgical interventions, the use of conservative therapies is emphasized before surgery is considered. Disease/disorder of the MPJ affects shoe wear, ambulation, and other activities of daily living.
Hallux valgus is classified as an abnormal deviation of the great toe towards the midline of the foot. Hallux rigidus is characterized by pain as well as a reduction in the range of motion (ROM), especially dorsiflexion, at the first MPJ.
The MPJ may become stiff (hallux rigidus), or deformed (hallux valgus). Both types of arthritis often affect the first MPJ located at the base of the big toe. The underlying causes of disease/disorder of the MPJ include osteoarthritis, rheumatoid arthritis, disease of the hallucal sesamoids and post-traumatic degeneration.
Most clinical presentations of the hallux (big toe) concern the metatarsal phalangeal joint (MPJ).