Cheilectomy: still a useful technique for grade I and grade II hallux limitus/rigidus.

Abstract

Cheilectomy, as applied to hallux limitus/rigidus, is described as resection of the dorsal osteophytes and lateral/medial margins of the first metatarsal, as well as the dorsal lip of the base of the proximal phalanx. Forty-seven patients underwent unilateral cheilectomy, with an average follow-up of 3.5 years, and an average patient age of 52 years. Dependent upon the progressive nature of the disease, the results varied with the most beneficial results in the early stages of hallux limitus/hallux rigidus, which include symptoms, re-operation, and range of motion. The indications for cheilectomy are hallux limitus/rigidus in grade I or grade II without sesamoid disease. Late grade II or grade III with sesamoid disease and degenerative joint disease are also described in terms of surgical treatment. The advantages of cheilectomy include early range of motion and rapid decrease in clinical symptoms; cheilectomy obviates the need for healing at an osteotomy site. The disadvantages include not addressing the underlying etiology, potential joint destruction, slippage, or pseudo-articulation at the joint's end range of dorsiflexion. It is not indicated in later stages of the disease.