Original Article

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


  • Umut Yavuz
  • Murat Gül
  • Devrim Özer
  • Bilal Demir
  • Ferdi Dırvar
  • Yavuz Kabukçuoğlu

Received Date: 19.03.2014 Accepted Date: 14.04.2014 Med Bull Haseki 2014;52(3):158-163


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.


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.


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° (7-24) valgus at the metatarsophalangeal joint and 11.9° (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.


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.

Keywords: Hallux rigidus, arthrodesis, screw, AOFAS, radiographic parameter

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