RADIOLOGIC ASSESSMENT OF THE OUTCOME OF K ELLER AND BRANDES ARTHROPLASTY FOR HALLUX-RIGIDUS

Purpose: The aim of this study was to evaluate the pre- and postoperat ive radiographic findings of hallux rigidus treated with Keller and Br andes arthroplasty to determine the radiographic outcome and to identi fy a prognostic marker. Methods: 83 patients with a total of 121 cases of hallux rigidus operated using Keller and Brandes arthroplasty were followed up (mean 9.7 y). A comparison of the pre-and postoperative r adiographs, the clinical and subjective findings was predicated on a f ive point scale: 1. percentage of proximal phalanx resected (< 33 %, 3 3-50 %, > 50 %), 2. joint space, 3. ratio of the length of the first a nd second metatarsals, 4. first intermetatarsal angle, and 5. hallux v algus angle. Results: In the patient group which had 33-50% of the pro ximal phalanx excised (n = 67. 55 %) the highest patient satisfaction was observed (96 %). If resection of the proximal phalanx exceeded 50% (n = 13. 11 %); non physiologic dorsiflexion of the toe occurred and patients were unsatisfied (62 %). Excision of less than 33 % of the ha llux (n = 41. 34 %) was associated with a recurrent hallux rigidus. No other evaluated radiological parameter proved to be of significance. Conclusion: The most important radiological parameter in the evaluatio n of the outcome of Keller and Brandes arthroplasty as a surgical trea tment method for hallux rigidus was the percentage of the proximal pha lanx which had hen excised.