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Manipulation and injection for hallux rigidus
IS IT WORTHWHILE?
M. C. Solan, J. D. F. Calder, S. P. Bendall
From the Princess Royal Hospital, Haywards Heath, England
M
anipulation of the metatarsophalangeal joint and
injection with steroid and local anaesthetic are
widely practised in the treatment of hallux rigidus,
but there is little information on the outcome. We
report the results of this procedure carried out on 37
joints, with a minimum follow-up of one year (mean,
41.2 months). Patients with mild (grade-1) changes
gained symptomatic relief for a median of six months
and only one-third required surgery. Two-thirds of
patients with moderate (grade-2) disease proceeded to
open surgery. In advanced (grade-III) hallux rigidus,
little symptomatic relief was obtained and all patients
required operative treatment. We recommend that
joints are graded before treatment and that
manipulation under anaesthetic and injection be used
only in early (grades I and II) hallux rigidus.
J Bone Joint Surg [Br] 2001;83-B:706-8. Full text
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Added: Thu Oct 25 2007
