Minimally invasive arthrodesis of the first metatarsophalangeal joint for hallux rigidus.

Background: First metatarsophalangeal joint arthrodesis plays a significant role in the management of symptomatic hallux rigidus. Several open and one percutaneous technique have been described in the literature. The authors present a minimally invasive technique, not previously published in the UK with patient-reported outcomes.

Methods: A total of 26 cases of are presented in this prospective, continuous series. Clinical outcome and patient satisfaction were assessed by the Manchester-Oxford Foot Questionnaire (MOXFQ) preoperatively and at most recent follow up (maximum 20 months). Radiographic and clinical evaluation of fusion was also assessed with a fusion rate of 93%.

Results: The MOXFQ score for cases where fusion was achieved improved from a mean of 42 points to 18 points at last follow up (p<0.05). Patient satisfaction was overall very good.

Conclusions: This minimally invasive technique is simple and can achieve results similar or better than open techniques in experienced hands. Postoperative care requirements are minimal and both clinical and patient-reported outcome show significant improvement in this series.