Primary Arthrodesis in the Treatment of High Grade Hallux Rigidus with Single Cortical Screw

Aim: The aim of this study was to evaluate the clinical and radiological results in patients with severe hallux rigidus who underwent arthrodesis using single cortical screw. Methods: We retrospectively evaluated 18 patients (16 females, 2 males) who underwent arthrodesis for severe hallux rigidus using single cortical screw. The mean age of the patients was 58.1 (range: 44-69) years. According to the Coughlin and Shurnas classification, 5 feet were rated as stage 3 and 13 feet were stage 4. 3 of the stage 3 patients had cheilectomy previously. The American Orthopaedic Foot and Ankle Society (AOFAS) clinical rating scale for the metatarsophalangeal - interphalangeal joints was used for clinical evaluation. Hallux valgus angles and hallux dorsiflexion angles were measured on X-rays. Results: The mean follow-up period was 32.4 (range: 15-69) months. Radiological signs of non-union was found in one patient. The mean preoperative AOFAS score was 56.1 ( range: 38-72). The mean final follow-up AOFAS score was found to be 81.1. Moderate results in 2 patients (11.1%), good results in 11 patients (61.1%) and excellent results in 5 patients (27.8%) were obtained. When the last X-rays were evaluated, 15.1 degrees (7-24) valgus at the metatarsophalangeal joint and 11.9 degrees (8-18) extension (to the floor) at the metatarsophalangeal joint were detected. Late surgical wound healing was observed in one patient. The screws were removed due to irritation in 8 (44%) patients. Conclusion: We assume that in the treatment of severe hallux rigidus, arthrodesis using a single cortical screw may be considered as a favorable surgical technique with its high union rates and increased functional results.