title: Biplanar proximal phalanx closing wedge osteotomy for hallux rigidus.
abstract: BACKGROUND
  Many procedures have been described for surgical treatment of symptomatic hallux rigidus. Dorsal cheilectomy of the metatarsophalangeal joint combined with a dorsal-based closing wedge osteotomy of the proximal phalanx (i.e., Moberg procedure) has been described as an effective procedure. For patients with hallux rigidus and clinically significant hallux valgus interphalangeus, the authors previously described a dorsal cheilectomy combined with a biplanar closing wedge osteotomy of the proximal phalanx, combining a Moberg osteotomy with an Akin osteotomy. The purpose of this study was to describe the clinical results of this procedure.
  
  
  METHODS
  This article is a retrospective review of prospectively gathered data that reports the clinical and radiographic results of dorsal cheilectomy combined with a biplanar oblique closing wedge proximal phalanx osteotomy (i.e., Moberg-Akin procedure) for patients with symptomatic hallux rigidus and hallux valgus interphalangeus. Consecutive patients were followed and evaluated for clinical and radiographic healing, satisfaction, and ultimate need for additional procedure(s). Thirty-five feet in 34 patients underwent the procedure.
  
  
  RESULTS
  All osteotomies healed. At an average of 22.5 months of follow-up, 90% of patients reported good or excellent results, with pain relief, improved function, and fewer shoe wear limitations following this procedure. Hallux valgus and hallux interphalangeal angles were radiographically improved. Other than one patient who requested hardware removal, no patients required additional surgical procedures.
  
  
  CONCLUSIONS
  Dorsal cheilectomy combined with a Moberg-Akin procedure was an effective and durable procedure with minimal morbidity in patients with hallux rigidus combined with hallux valgus interphalangeus.
authors.affiliation: Department of Orthopaedics, Stanford University, Redwood City, CA 94063, USA. kjhunt@stanford.edu
authors.forename: Kenneth John
authors.initials: KJ
authors.lastname: Hunt
authors.forename: Robert B
authors.initials: RB
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D020859:Hallux Rigidus / Q000000981:diagnostic imaging / Q000601:surgery*; D006215:Hallux Valgus / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D050277:Toe Phalanges / Q000000981:diagnostic imaging / Q000601:surgery*