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Plantar Pressure and Joint Motion After the Youngswick Procedure for Hallux Limitus

Alan R. Bryant, PhD, MSc(Pod) ^*, Paul Tinley, PhD  and Joan H. Cole, PhD 

^* Private practice, Subiaco, Western Australia, Australia.
Department of Podiatry, Charles Sturt University, Albury-Wodonga, New South Wales, Australia.
School of Physiotherapy, Curtin University of Technology, Bentley, Western Australia, Australia.

Corresponding author: Alan R. Bryant, PhD, MSc(Pod), 5/20 Churchill Ave, Subiaco, Western Australia 6008, Australia.

Abstract

The effects of the Youngswick osteotomy on plantar peak pressure distribution in the forefoot are presented for 17 patients (23 feet) with mild-to-moderate hallux limitus deformity and 23 control subjects (23 feet). During 2 years of follow-up, the operation produced a significant increase in the range of dorsiflexion of the first metatarsophalangeal joint in these patients, reaching near-normal values. Preoperative and postoperative measurements, using a pressure-distribution measurement system, show that peak pressure beneath the hallux and the first metatarsal head remained unchanged. However, peak pressure was significantly increased beneath the second metatarsal head and decreased beneath the fifth metatarsal head. These findings suggest that the foot functioned in a less inverted manner postoperatively. Compared with normal feet, hallux limitus feet demonstrated significantly higher peak pressure beneath the fourth metatarsal head preoperatively and postoperatively. (J Am Podiatr Med Assoc 94(1): 22-30, 2004)