Hallux Limitus

Hallux limitus, also known as a dorsal bunion, is a form of arthritis in which the big toe stiffens to the point that its ability to flex upwards is significantly reduced. This stiffness, accompanied by swelling and pain around the joint, interferes with normal movement, causing difficulty in walking, standing, bending, squatting and running. While the condition is degenerative and sometimes associated with aging, it may occur in young people, especially athletes, due to traumatic injury.

If not properly treated, the toe joint will become increasingly painful, deformed and totally immovable, a condition referred to at hallux rigidus. In addition to injury and aging, risk factors for development of hallux limitus include hereditary predisposition, flat feet, ill-fitting shoes and underlying disease conditions such as rheumatoid arthritis or gout.

Treatment of Hallux Limitus

There are several forms of treatment for hallux limitus. The more conservative, nonsurgical treatments include:

  • Avoiding activities that cause pain, such as running
  • Shoe alterations to relieve pressure on the affected joint
  • Prescription orthotics
  • Oral anti-inflammatory medications
  • Physical therapy
  • Injection of corticosteroids

If these methods do no sufficiently relieve the condition, surgery will be necessary to reduce swelling and relieve pain. There are several surgical procedures possible for hallux limitus:

  • Cheilectomy in which bone spurs are shaved
  • Osteotomy, in which the toe bone is cut and realigned
  • Arthrodesis in which the bones are fused
  • Arthroplasty in which the joint is repaired or replaced

Which surgery is necessary or appropriate will be decided on an individual basis determined by the patient's needs and condition.

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