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  • Title: Medially based hallux interphalangeal joint arthroplasty in the management of hallux ulceration: surgical technique and result in six consecutive cases.
    Author: Ehredt DJ, Reiner MM, Schnack LL, Reardon BK.
    Journal: Wounds; 2023 Apr; 35(4):80-84. PubMed ID: 37023476.
    Abstract:
    INTRODUCTION: Plantar hallux wounds are common in patients with diabetic neuropathy. Several techniques, both surgical and nonsurgical, are designed to offload plantar wounds. However, controversy exists regarding which techniques are superior in terms of efficacy, safety, and longevity. OBJECTIVE: This manuscript presents a simple, minimally invasive technique to permanently offload the plantar IPJ of the hallux in the case of recalcitrant plantar ulcerations. The authors describe their surgical technique for and outcomes of medially based hallux IPJ arthroplasty for the management of recalcitrant hallux ulcerations. MATERIALS AND METHODS: Five patients (6 wound cases) were evaluated. All patients underwent the same surgical procedure and were subject to the same postoperative protocol of full weight-bearing as tolerated. RESULTS: All 5 cases healed, with an average time to healing of 15.5 days (range, 10-22 days) and no instances of recurrence. The average time to final follow-up was 83.17 weeks (range, 54-95 weeks). CONCLUSIONS: The medially based hallux IPJ arthroplasty approach has demonstrated ability to adequately offload hallux ulcerations, permits bone biopsy or resection for treatment of underlying bone infection, and allows for immediate weight-bearing.
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