Bunion with Stiff and PainfulcToe Joint, (Hallux Limitus)
Hallux Limitus is defined as a deformity of the first metatarsophalangeal joint (1st MPJ) or bunion joint that restricts the range of motion and often causes pain in the joint. Normally, the range of motion is about 60 degrees. With hallux limitus, there can be a little as no motion in the joint. Often there is significant arthritis associated with the 1st MP joint, which is clearly visible on x-ray.
There are several common causes of hallux limitus. One cause is simply a gradual deterioration of the joint due to age. There could be a history of trauma to the foot or joint, which may have begun the deterioration of the joint years before. Sports injuries or dropping a heavy object on the foot can cause the problem.
Different grades of the deformity exist from mild to severe, with the amount of joint motion typically decreasing over time. Patients with hallux limitus usually exhibit pronated or flat feet during gait and stance.
Orthotics For Hallux Limitus
Orthotics are an important conservative therapy for hallux limitus because an orthotic can help control the abnormal pronatory forces that are created during gait. Orthotics can serve as an alternative treatment to surgery during the early stages of hallux limitus. Orthotics also can act as a postoperative tool to limit the biomechanical influences that caused hallux limitus, thus reducing the chance of reoccurrence of symptoms.
Surgical Options for Hallux Limitus
When the conservative option of using orthotics is ineffective, then surgery should be considered. The surgical procedure consists of a specialized type of bunionectomy procedure, where the abnormal and arthritic portion of bone of the bunion joint is removed and it is replaced by an implant or plastic joint. The procedure is called a "bunionectomy with an implant." The bunionectomy with implant procedure is much easier than a common hip joint replacement, and takes approximately 40 minutes. Patients can walk on the foot, using a special surgical shoe, immediately after the surgery, without crutches, walkers, or a cast.
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