Therapy of Osteoarthritis Of the Great Toe and Hallux Rigidus

Abstract

To the Editor.— Please permit me to add to the already excellent answer given to the question on the Treatment of Osteoarthritis of the Great Toe and Hallux Rigidus (216: 1207, 1971). Whereas x-ray film and clinical findings may indicate a severe degree of bony ankylosis and loss of motion, the injection of 2 cc of 2% lidocaine (Xylocaine) dorsally and into the first intermetatarsal space at the level of the metatarsal heads often results in a gratifying increase in the range of motion. A 24-gauge five-eighths inch needle is used and intraarticular injection is avoided. Apparently a great deal of the limited motion is caused by muscle splinting around the painful joint. If moderately forced dorsiflexion and plantar flexion are induced after the injection and repeated at weekly intervals, progressive and lasting improvement often occurs. In a series of 100 consecutive cases of hallux rigidus without complicating factors such