Modified Youngswick Osteotomy for Treatment of Hallux Rigidus in Athletes

Category: Midfoot/Forefoot; Sports Introduction/Purpose: Hallux rigidus is a common condition that affects athletes, particularly those who engage in high-impact sports. This condition results in pain and limited range of motion in the big toe, and can significantly affect an athlete's performance. The goal of treatment is to alleviate pain, improve function, and return the athlete to their sport. There are various surgical options available for treating hallux rigidus, one of which is the Youngswick osteotomy. This procedure involves realigning the bones of the big toe to relieve pressure and improve range of motion. Methods: A retrospective study was conducted to evaluate the effectiveness of the modified Youngswick osteotomy in treating hallux rigidus in athletes. The study included 40 patients, with a median follow-up of 40 months. The patients were divided into two groups based on sex: 29 female and 11 male. The side affected was also recorded, with 26 patients having the condition on their right foot and 14 on their left. The grade of hallux rigidus was also recorded, with 25 patients having grade II and 15 patients having grade III. Results: The study found that the median preoperative American Orthopaedic Foot & Ankle Society (AOFAS) score was 39, with a range of 25-60. After the Youngswick osteotomy, the median AOFAS score improved to 81.8, with a range of 50-90. This improvement was statistically significant (p < .0001). The range of motion (ROM) of the big toe also improved after the surgery, with the median preoperative ROM being 15.4 degrees and the median postoperative ROM being 54 degrees. Subjective satisfaction with the surgery was also recorded, with 80% of patients reporting excellent results, 10% good results, 7.5% fair results, and 2.5% poor results. The study found that there was no significant difference in the results based on sex or the side affected. Conclusion: The results of this study suggest that the Youngswick osteotomy is an effective treatment option for hallux rigidus in athletes. The procedure significantly improves pain, range of motion, and overall function, allowing athletes to return to their sport. The results of this study provide valuable information for clinicians who are considering the modified Youngswick osteotomy for their patients with hallux rigidus. However, it should be noted that further research is needed to confirm these findings and to determine the long-term outcomes of this procedure.