The use of osteotomies in the treatment of hallux limitus and hallux rigidus.

Though osteotomies for relief of hallux limitus and rigidus have been around since the earliest surgical corrections, no sound clinical studies have been performed to warrant their use over the standard accepted techniques of cheilectomy and arthrodesis. These operations are surely more technically demanding than such standard procedures, and involve significant increased risk and postoperative immobilization than cheilectomy alone. Sound theories such as metatarsus primus elevatus and excessive metatarsal length contributing to hallux rigidus have never been proven, and no accurate way to diagnose these structural deformities has been proposed. These operations are intriguing and some make clinical sense. It remains to be seen whether the orthopedic community will adopt them based on their merits.