Surgical management of hallux rigidus: cheilectomy and osteotomy (phalanx and metatarsal).

Cheilectomy has long been the standard treatment in the orthopedic community for mild to moderate cases of hallux rigidus, with established long-term excellent results. Osteotomies of the proximal phalanx and first metatarsal have been described mainly in the podiatric literature; they have shown good outcomes in small patient groups with short-term follow-up. Proper patient selection is critical to obtaining favorable outcomes with any of the joint-sparing procedures. Patients with severe arthritic changes and pain in the midrange arc of motion have poorer outcomes with these procedures and are better served with joint-destructive procedures, such as arthroplasty or arthrodesis.