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Surgical management of persistent dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe is indicated in patients with marked rigidity and pain, following failure of conservative management with appropriate orthoses and shoes with a wide toe box.
Hallux rigidus is the clinical expression of osteoarthritis of the metatarsophalangeal joint of the hallux. Hallux rigidus presents with limited joint mobility, especially in extension, and pain, with osteophytes on the dorsal aspect of the head of the first metatarsal (Fig. 5.1) and of the base of the proximal phalanx of the hallux. It has a prevalence of 2% of the population between 30 and 60 years...