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Management of Hallux Limitus with Distraction of the First Metatarsophalangeal Joint

Leonard M. Talarico, DPM ^*, George R. Vito, DPM ^*, Larry Goldstein, DPM  and Adam D. Perler, DPM 

^* Atlanta Leg Lengthening and Deformity Correction Center, Macon, GA.
Private practice, Foot and Leg Center of Georgia, Macon.
Palmetto General Hospital, Hialeah, FL.

Corresponding author: George R. Vito, DPM, Atlanta Leg Lengthening and Deformity Correction Center, 3556 Riverside Dr, Macon, GA 31210.

Abstract

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. (J Am Podiatr Med Assoc 95(2): 121–129, 2005)