Hallux Rigidus: A Treatment Algorithm

First metatarsophalangeal joint osteoarthritis, commonly known as hallux rigidus, is a progressive disabling condition. Several staging classification systems exist. We present a staging system incorporating radiographic findings, range of motion, and presence or absence of mid-motion pain and sesamoid pain. On the basis of these clinically significant variables, we present an algorithm for treatment of the various clinical manifestations of hallux rigidus. Finally, we describe these surgical techniques, with particular attention to cheilectomy, hemiarthroplasty, and arthrodesis.