Hallux rigidus treatment
I have had several patients this week referred to me for orthotics by the podiatrist at our facility. Each one has hallux rigidus with dorsal spurring but not all for the same mechanical reason. In the past I have successfully treated this with some supination force and a Morton's Extension (my lab uses korex). The one patient I am concerned about this week has bilateral rigid plantarflexed first rays but symptoms only at the left first MTPJ. Her left midtarsal joint is more restricted than the right. My thought is that the ground reaction force probably acts more at the first ray attempting to dorsiflex it resulting in dorsal compression.
Here's my concern...given the rigid plantarflexed first rays, I'm concerned about using a Morton's Extension (DPM wants me to extend the shell for a rigid extension). It will help decrease motion at the painful MTP joint, but will it also increase the dorsiflexion force under the MTP? How do others address this?
Thank you!
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