title: [Proposed global treatment algorithm for hallux rigidus according to evidence-based medicine].
abstract: BACKGROUND
  Hallux rigidus is the most common arthritis of the foot and ankle. There are numerous reviews on the surgical treatment, but few publications that address the effectiveness of conservative treatment.
  
  
  OBJECTIVE
  To present a comprehensive algorithm for treatment of all grades of this disease.
  
  
  METHODS
  Literature search in the following sources: Pubmed and PEDro database (physiotherapy evidence database) until October 2013 for articles on treatment hallux rigidus to record levels of evidence.
  
  
  RESULTS
  A total of 112 articles were obtained on conservative treatment and 609 on surgical treatment. Finally, only 4 met the inclusion criteria.
  
  
  CONCLUSIONS
  The use of orthoses or footwear modifications, infiltration with hyaluronate, cheilectomy in moderate degrees and the metatarsophalangeal arthrodesis for advanced degrees, are the only procedures contrasted with grade B or moderate evidence in the treatment of hallux rigidus.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Canarias, Tenerife, España; Facultad de Medicina, Universidad de La Laguna, Tenerife, España; Unidad de Tobillo y Pie, Hospital Universitario de Canarias, Tenerife, España. Electronic address: herrera42@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Herrera-Pérez
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Canarias, Tenerife, España.
authors.forename: C
authors.initials: C
authors.lastname: Andarcia-Bañuelos
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Canarias, Tenerife, España.
authors.forename: J
authors.initials: J
authors.lastname: de Bergua-Domingo
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Basilea, Basilea, Suiza.
authors.forename: J
authors.initials: J
authors.lastname: Paul
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Basilea, Basilea, Suiza.
authors.forename: A
authors.initials: A
authors.lastname: Barg
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Basilea, Basilea, Suiza.
authors.forename: V
authors.initials: V
authors.lastname: Valderrabano
mesh_terms: D000465:Algorithms; D001174:Arthrodesis; D000066491:Clinical Decision-Making / Q000379:methods*; D003131:Combined Modality Therapy; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D061826:Foot Orthoses; D020859:Hallux Rigidus / Q000628:therapy*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D055675:Viscosupplements / Q000627:therapeutic use
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Conservative treatment; Evidence-based medicine; Hallux rigidus; Medicina basada en la evidencia; Surgical treatment; Tratamiento conservador; Tratamiento quirúrgico