what's new in surgical options for hallux rigidus? by sandro giannini, francesco ceccarelli,...

18
What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca Vannini J Bone Joint Surg Am Volume 86(suppl 2):72-83 December 1, 2004 ©2004 by The Journal of Bone and Joint Surgery, Inc.

Upload: conrad-flynn

Post on 05-Jan-2016

215 views

Category:

Documents


1 download

TRANSCRIPT

Page 1: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

What's New in Surgical Options for Hallux Rigidus?

by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca Vannini

J Bone Joint Surg AmVolume 86(suppl 2):72-83

December 1, 2004

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 2: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

During the propulsive phase of gait, the hallux is unable to dorsiflex adequately.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 3: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Radiographic classification of hallux rigidus.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 4: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Plantar release for grade-0 hallux rigidus.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 5: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Sliding osteotomy for grade-1 hallux rigidus.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 6: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Modified chevron osteotomy for grade-1 hallux rigidus.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 7: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Cheilectomy for grade-2 hallux rigidus.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 8: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Arthrodesis for grade-3 hallux rigidus.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 9: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Arthrodesis.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 10: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Arthroplasty with use of a poly(DL-lactic acid) spacer.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 11: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Scores on the American Orthopaedic Foot and Ankle Society scale obtained preoperatively and at the time of follow-up.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 12: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

The mean range of motion of the first metatarsophalangeal joint, measured preoperatively and at the time of follow-up, in patients who did not undergo arthrodesis of the first

metatarsophalangeal joint.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 13: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Figs. 12-A and 12-B The foot of a twenty-eight-year-old man with grade-0 hallux rigidus.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 14: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

An excellent radiographic (B) and clinical (B) result was maintained at four years after a plantar release.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 15: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

The foot of a forty-five-year-old woman with grade-1 posttraumatic hallux rigidus associated with a valgus deformity (A).

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 16: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 17: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.

Page 18: What's New in Surgical Options for Hallux Rigidus? by Sandro Giannini, Francesco Ceccarelli, Cesare Faldini, Roberto Bevoni, Gianluca Grandi, and Francesca

A fifty-two-year-old woman with grade-3 hallux rigidus following a failed Keller procedure.

Sandro Giannini et al. J Bone Joint Surg Am 2004;86:72-83

©2004 by The Journal of Bone and Joint Surgery, Inc.