Hallux rigidus (synonyms: Osteoarthritis of the metatarsophalangeal joint; metatarsophalangeal joint stiffness; hallux non extensus; hallux flexus; hallux limitus; wear and tear of the metatarsophalangeal joint; ICD-10-GM M20.2: Hallux rigidus) refers to the metatarsophalangeal joint of the big toe that has become stiff due to arthritic changes. The mobility of the metatarsophalangeal joint of the big toe is restricted and painful. Rolling over the big toe is particularly painful.
Hallux rigidus often occurs together with a valgus position (from Latin valgus = crooked) of the big toe, the so-called hallux valgus. After hallux valgus, hallux rigidus is the second most common functional disorder of the big toe (hallux valgus: hallux rigidus = 7: 1; prevalence of hallux valgus is 23% of those aged < 65 and approx. 35% of those aged > 65).
Hallux rigidus often occurs on one side only.
The following forms of hallux rigidus are distinguished:
- Early stage – mild form
- Painful restriction of movement of the big toe, especially when rolling.
- Here, the wearing of appropriate shoe inserts or orthopedic footwear is sufficient at first.
- Middle stage – moderate (moderate) form.
- Increasing pain
- Increasing restriction of movement
- As a rule, joint-preserving surgery (combined bone and soft tissue surgery) is performed. Goal: dissolve stuck structures and improve the joint mechanics.
- Late stage – severe form
- Typical: full-blown osteoarthritis
- Surgery fusing the metatarsophalangeal joint should be considered.
Sex ratio: men are more commonly affected than women.
Frequency peak: the disease occurs from the 4th / 5th decade of life.
Course and prognosis: Initially, conservative therapy (pharmacotherapy / drug therapy and physical measures) is performed. If the results are not satisfactory or if the disease is already too advanced, surgical therapy should be considered. If left untreated, joint stiffness of the metatarsophalangeal joint will occur in the long term.
