At Shoreline Orthopaedics, our orthopaedic surgeons use a truly collaborative approach so our patients have the benefit of multiple expert opinions, without having to go elsewhere to obtain them.
Shoreline Orthopaedics provides more comprehensive services, state-of-the-art options, technologies and techniques than anyone else in the area.
The following information is provided to help you understand what you can expect from us regarding policies and procedures, and also what is expected of you before and after treatment or procedures.
The following information is provided to help you gain a better understanding of anatomy, terminology, certain orthopaedic procedures, and more. If you have any questions, feel free to ask your physician.
Nearly one-fourth of all bones in the human body are in the feet. The foot is a complex, flexible structure that contains bones, joints, and more than 100 muscles, tendons and ligaments, all working together to enable movement and balance. The foot is divided into three sections, the forefoot, the midfoot and the hindfoot. The forefoot has five toes (14 phalanges) and five longer bones (metatarsals). One phalanx of each of the five toes connects to one of the five metatarsals.
The big toe, or great toe (hallux), is made up of two joints. The metatarsophalangeal joint (MTP) is the largest of these, and the closest to the base of the toe, where the first long bone of the foot (metatarsal) meets the first bone of the toe (phalanx). In the MTP joint, as in any joint, the ends of the bones, where they touch, are covered by articular cartilage, a smooth substance that protects the bones and enables the joint to move easily.
Hallux rigidus usually develops in adults between the ages of 30 and 60 years, and occurs most commonly at the base of the big toe, or MTP joint. When articular cartilage in the MTP joint is damaged by wear-and-tear or injury, the raw bone ends can rub together and a spur, or overgrowth, may develop on the top of the bone. This overgrowth prevents the toe from bending adequately, resulting in hallux rigidus, or a stiff big toe. Because the MTP joint must bend with each step, hallux rigidus can make walking painful and difficult.
Common symptoms of hallux rigidus include:
Hallux rigidus may result from an injury to the toe that damages the articular cartilage, or it may be caused from differences in foot anatomy that increase stress on the joint. Why it appears in some people but not others is currently unknown.
Pain relievers and anti-inflammatory medications (NSAIDs) such as ibuprofen may help reduce the swelling and ease the pain. Applying ice packs or taking contrast baths may also help reduce inflammation and control symptoms for a short period of time. Wearing a shoe with a large toe box will lessen the pressure on the toe, and patients typically must give up wearing high heels. Your doctor may recommend that you wear a stiff-soled shoe with a rocker or roller-bottom design, and possibly a shoe with a steel shank or metal brace in the sole. These types of shoes support the foot when walking and reduce bending of the big toe.
If nonsurgical treatment does not provide relief for your symptoms, your orthopaedic surgeon may discuss surgical options with you. These may include:
With any surgery there are some risks, and these vary from person to person. Complications are typically minor, treatable and unlikely to affect your final outcome. Your orthopaedic surgeon will speak to you prior to surgery to explain any potential risks and complications that may be associated with your procedure.