• AIM
    • To determine the effectiveness of manipulation under anaesthesia and local steroid injection to treat stiffness of the first metatarsophalangeal joint following surgery for hallux rigidus or hallux valgus.
  • METHODS
    • Patients were identified who had undergone surgery for hallux rigidus or hallux valgus and subsequently were treated with manipulation and steroid injection for stiffness of their joint. Patient records were reviewed to determine the range of movement of the joint pre-operatively, immediately following the procedure and at subsequent follow up. Manchester-Oxford foot questionnaires (MOXFQ) were sent to patients to evaluate symptoms post-operatively.
  • RESULTS
    • In total 35 patients were analysed, which included a total of 38 foot operations. Twenty seven had prior surgery for hallux rigidus and 11 for hallux valgus correction. The total range of movement of the joint improved following manipulation by an overall mean of 44.7° (p<0.0001). At subsequent follow up, the total range of movement of the joint was still improved by 22.2° (p<0.0001) overall. The mean post-operative MOXFQ score was 24.8 but no correlation was found between MOXFQ scores and range of movement.
  • CONCLUSIONS
    • Manipulation under anaesthesia and local steroid injection is an effective way of treating stiffness following first ray surgery. Treatment results in an improved range of movement of the joint and patients report good function post-operatively.