{"id":5652,"date":"2023-04-13T16:22:16","date_gmt":"2023-04-13T16:22:16","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/hallux-rigidus-fr\/"},"modified":"2023-04-21T16:28:13","modified_gmt":"2023-04-21T16:28:13","slug":"hallux-rigidus-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/hallux-rigidus-fr\/","title":{"rendered":"L&rsquo;hallux rigidus"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\">\n<p><b>\u00c9diteur original <\/b>&#8211; <a href=\"\/User:Tracy_Hall\" title=\"User:Tracy Hall\">Tracy Hall<\/a><\/p>\n<p><b>Principaux contributeurs<\/b> &#8211; <a href=\"\/User:Admin\" class=\"mw-userlink\" title=\"User:Admin\"><bdi>Admin<\/bdi><\/a>, <a href=\"\/User:Ewa_Jaraczewska\" class=\"mw-userlink\" title=\"User:Ewa Jaraczewska\"><bdi>Ewa Jaraczewska<\/bdi><\/a>, <a href=\"\/User:Rachael_Lowe\" class=\"mw-userlink\" title=\"User:Rachael Lowe\"><bdi>Rachel Lowe<\/bdi><\/a> , <a href=\"\/User:Tracy_Hall\" class=\"mw-userlink\" title=\"User:Tracy Hall\"><bdi>Tracy Hall<\/bdi><\/a>, <a href=\"\/User:Jess_Bell\" class=\"mw-userlink\" title=\"User:Jess Bell\"><bdi>Jess Bell<\/bdi><\/a>, <a href=\"\/User:Laura_Ritchie\" class=\"mw-userlink\" title=\"User:Laura Ritchie\"><bdi>Laura Ritchie<\/bdi><\/a>, <a href=\"\/User:Kim_Jackson\" class=\"mw-userlink\" title=\"User:Kim Jackson\"><bdi>Kim Jackson<\/bdi><\/a>, <a href=\"\/User:Ilse_De_Bode\" class=\"mw-userlink\" title=\"User:Ilse De Bode\"><bdi>Ilse De Bode<\/bdi><\/a>, <a href=\"\/User:Simisola_Ajeyalemi\" class=\"mw-userlink\" title=\"User:Simisola Ajeyalemi\"><bdi>Simisola Ajeyalemi<\/bdi><\/a> et <a href=\"\/User:Khloud_Shreif\" class=\"mw-userlink\" title=\"User:Khloud Shreif\"><bdi>Khloud Shreif<\/bdi><\/a>  <\/p>\n<\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input type=\"checkbox\" role=\"button\" id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display:none\"><\/p>\n<div class=\"toctitle\" lang=\"en\" dir=\"ltr\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<p><span class=\"toctogglespan\"><label class=\"toctogglelabel\" for=\"toctogglecheckbox\"><\/label><\/span><\/p>\n<\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Introduction\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Introduction<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Clinically_Relevant_Anatomy\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">Anatomie cliniquement pertinente<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-3\"><a href=\"#Structure\"><span class=\"tocnumber\">2.1<\/span> <span class=\"toctext\">La structure <\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-4\"><a href=\"#Range_of_Motion\"><span class=\"tocnumber\">2.2<\/span> <span class=\"toctext\">Amplitude de mouvement<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-5\"><a href=\"#Function_of_the_Hallux\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Fonction de l&rsquo;hallux<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Aetiology\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">\u00c9tiologie<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-7\"><a href=\"#Risk_Factors\"><span class=\"tocnumber\">4.1<\/span> <span class=\"toctext\">Facteurs de risque<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-8\"><a href=\"#Clinical_Presentation\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">Pr\u00e9sentation clinique<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-9\"><a href=\"#Diagnostic_Procedures\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Proc\u00e9dures de diagnostic<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#Radiograph\"><span class=\"tocnumber\">6.1<\/span> <span class=\"toctext\">Radiographie<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#Classification_Systems_for_Hallux_Rigidus\"><span class=\"tocnumber\">6.2<\/span> <span class=\"toctext\">Les syst\u00e8mes de classification de l&rsquo;hallux rigidus<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-12\"><a href=\"#Regnauld_Classification.5B18.5D\"><span class=\"tocnumber\">6.2.1<\/span> <span class=\"toctext\">Classification de Regnauld <sup>(18)<\/sup><\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-13\"><a href=\"#Hattrup_and_Johnson_Classification.5B19.5D.5B18.5D\"><span class=\"tocnumber\">6.2.2<\/span> <span class=\"toctext\">Classification de Hattrup et Johnson <sup>(19) <\/sup><sup>(18)<\/sup><\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-14\"><a href=\"#Coughlin_and_Shurnass_Classification\"><span class=\"tocnumber\">6.2.3<\/span> <span class=\"toctext\">Classification de Coughlin et Shurnass<\/span><\/a><\/li>\n<li class=\"toclevel-3 tocsection-15\"><a href=\"#Roukis_Classification.5B18.5D\"><span class=\"tocnumber\">6.2.4<\/span> <span class=\"toctext\">Classification de Roukis <sup>(18)<\/sup><\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-16\"><a href=\"#Examination\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Examen<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-17\"><a href=\"#Non-Surgical_Management\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">Traitement non chirurgical<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-18\"><a href=\"#Pharmacology\"><span class=\"tocnumber\">8.1<\/span> <span class=\"toctext\">Pharmacologie<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-19\"><a href=\"#Footwear.2C_Insoles_and_Orthotics\"><span class=\"tocnumber\">8.2<\/span> <span class=\"toctext\">Chaussures, semelles et orth\u00e8ses<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-20\"><a href=\"#Manual_Techniques\"><span class=\"tocnumber\">8.3<\/span> <span class=\"toctext\">Techniques manuelles<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-21\"><a href=\"#Stretching_and_Strengthening\"><span class=\"tocnumber\">8.4<\/span> <span class=\"toctext\">\u00c9tirements et renforcement<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-22\"><a href=\"#Conditioning\"><span class=\"tocnumber\">8.5<\/span> <span class=\"toctext\">Conditionnement<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-23\"><a href=\"#Activity_Modification\"><span class=\"tocnumber\">8.6<\/span> <span class=\"toctext\">Modification des activit\u00e9s<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-24\"><a href=\"#Surgical_therapy\"><span class=\"tocnumber\">8.7<\/span> <span class=\"toctext\">Traitement chirurgical<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-25\"><a href=\"#Differential_Diagnosis\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">Diagnostic diff\u00e9rentiel<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-26\"><a href=\"#Resources\"><span class=\"tocnumber\">10<\/span> <span class=\"toctext\">Ressources<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-27\"><a href=\"#References\"><span class=\"tocnumber\">11<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span class=\"mw-headline\" id=\"Introduction\">Introduction<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=1\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Introduction\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=1\" title=\"Edit section: Introduction\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;hallux rigidus est une affection d\u00e9g\u00e9n\u00e9rative arthrosique de la premi\u00e8re articulation m\u00e9tatarsophalangienne (MTP-1).<sup id=\"cite_ref-:11_1-0\" class=\"reference\"><a href=\"#cite_note-:11-1\">(1)<\/a><\/sup> Elle se caract\u00e9rise par une <i>absence totale<\/i> de mouvement de l&rsquo;articulation dans le plan sagittal, en particulier la dorsiflexion, aux stades avanc\u00e9s de la maladie.<sup id=\"cite_ref-2\" class=\"reference\"><a href=\"#cite_note-2\">(2)<\/a><\/sup> L&rsquo;hallux limitus est le nom donn\u00e9 au premier stade de cette affection lorsqu&rsquo;il y a <i>restriction<\/i> dans le plan sagittal de mouvement.<sup id=\"cite_ref-:1_3-0\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup> Cet article aborde plusieurs concepts de traitement conservateur et les principales proc\u00e9dures chirurgicales utilis\u00e9es pour traiter l&rsquo;hallux rigidus.<\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width:302px;\"><a href=\"\/File:Foot_inferior.png\" class=\"image\"><img loading=\"lazy\" alt=\"\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e5\/Foot_inferior.png\/300px-Foot_inferior.png\" decoding=\"async\" width=\"300\" height=\"300\" class=\"thumbimage\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e5\/Foot_inferior.png\/450px-Foot_inferior.png 1.5x, https:\/\/www.physio-pedia.com\/images\/e\/e5\/Foot_inferior.png 2x\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><a href=\"\/File:Foot_inferior.png\" class=\"internal\" title=\"Enlarge\"><\/a><\/div>\n<p>Face plantaire du pied<\/p>\n<\/div>\n<\/div>\n<\/div>\n<h2><span class=\"mw-headline\" id=\"Clinically_Relevant_Anatomy\">Anatomie cliniquement pertinente <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=2\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinically Relevant Anatomy\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=2\" title=\"Edit section: Clinically Relevant Anatomy\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span class=\"mw-headline\" id=\"Structure\">La structure<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=3\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Structure\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=3\" title=\"Edit section: Structure\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>La premi\u00e8re articulation m\u00e9tatarsophalangienne est constitu\u00e9e de plusieurs structures anatomiques qui, lors d&rsquo;activit\u00e9s sportives, supportent un poids jusqu&rsquo;\u00e0 huit fois sup\u00e9rieur \u00e0 celui du corps.<sup id=\"cite_ref-4\" class=\"reference\"><a href=\"#cite_note-4\">(4)<\/a><\/sup><\/p>\n<p><b>Composants osseux <\/b>:<\/p>\n<ul>\n<li>La <i>t\u00eate du premier m\u00e9tatarsien<\/i> pr\u00e9sente deux rainures sur sa surface plantaire qui accueille les surfaces articulaires des os s\u00e9samo\u00efdes m\u00e9dial et lat\u00e9ral. Les l\u00e9sions cartilagineuses apparaissent principalement sur la face dorsale de la premi\u00e8re t\u00eate m\u00e9tatarsienne.<sup id=\"cite_ref-:2_5-0\" class=\"reference\"><a href=\"#cite_note-:2-5\">(5)<\/a><\/sup><\/li>\n<li>La <i>phalange proximale<\/i> sert de point d&rsquo;attache aux muscles et aux ligaments.<\/li>\n<li>Les <i>os s\u00e9samo\u00efdes m\u00e9dial (tibial) et lat\u00e9ral (fibulaire)<\/i> sont situ\u00e9s sur la face plantaire de la premi\u00e8re t\u00eate m\u00e9tatarsienne.<\/li>\n<\/ul>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width:302px;\"><a href=\"\/File:Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\" class=\"image\"><img loading=\"lazy\" alt=\"\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e1\/Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/300px-Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\" decoding=\"async\" width=\"300\" height=\"347\" class=\"thumbimage\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e1\/Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/450px-Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/e\/e1\/Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\/600px-Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg 2x\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><a href=\"\/File:Normal_Plantar_Plate_-_Adapted_Shutterstock_Image_-_ID_566637886.jpg\" class=\"internal\" title=\"Enlarge\"><\/a><\/div>\n<p>Plaque plantaire<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p><b>Le complexe de la plaque plantaire du gros orteil :<\/b><\/p>\n<p>Ce coussinet fibrocartilagineux forme une unit\u00e9 fonctionnelle avec la face plantaire de la capsule articulaire, le ligament inters\u00e9samo\u00efdien, les ligaments lat\u00e9raux (m\u00e9tatarsos\u00e9samo\u00efdiens et m\u00e9tatarsophalangien horizontal) et les structures musculotendineuses de la premi\u00e8re articulation MTP. Son r\u00f4le consiste notamment \u00e0<\/p>\n<ul>\n<li>r\u00e9partir le poids du corps sur les s\u00e9samo\u00efdes<\/li>\n<li>prot\u00e9ger les surfaces articulaires<\/li>\n<li>permettre le glissement de la t\u00eate m\u00e9tatarsienne le long de la capsule articulaire et au niveau des petites articulations s\u00e9samo\u00efdes<\/li>\n<li>aider \u00e0 la propulsion pendant la marche et les activit\u00e9s sportives<\/li>\n<li>permettre une acc\u00e9l\u00e9ration efficace et le maintien d&rsquo;un \u00e9quilibre optimal du corps<\/li>\n<\/ul>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width:302px;\"><a href=\"\/File:Ligaments_of_the_foot_dorsal_aspect_Primal.png\" class=\"image\"><img loading=\"lazy\" alt=\"\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/08\/Ligaments_of_the_foot_dorsal_aspect_Primal.png\/300px-Ligaments_of_the_foot_dorsal_aspect_Primal.png\" decoding=\"async\" width=\"300\" height=\"300\" class=\"thumbimage\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/0\/08\/Ligaments_of_the_foot_dorsal_aspect_Primal.png\/450px-Ligaments_of_the_foot_dorsal_aspect_Primal.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/0\/08\/Ligaments_of_the_foot_dorsal_aspect_Primal.png\/600px-Ligaments_of_the_foot_dorsal_aspect_Primal.png 2x\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><a href=\"\/File:Ligaments_of_the_foot_dorsal_aspect_Primal.png\" class=\"internal\" title=\"Enlarge\"><\/a><\/div>\n<p>Ligaments du pied (face dorsale)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p><b>Ligaments collat\u00e9raux :<\/b><\/p>\n<p>Les ligaments m\u00e9tatarsophalangiens m\u00e9dial et lat\u00e9ral (ligaments collat\u00e9raux) naissent du tubercule du condyle m\u00e9tatarsien et s&rsquo;ins\u00e8rent dans le tubercule \u00e0 la base de la phalange proximale. Bien qu&rsquo;ils n&rsquo;appartiennent pas au complexe de la plaque plantaire, ils assurent une stabilisation statique lorsque des forces de valgus ou de varus sont appliqu\u00e9es \u00e0 l&rsquo;articulation.<\/p>\n<div class=\"thumb tright\">\n<div class=\"thumbinner\" style=\"width:302px;\"><a href=\"\/File:Muscles_of_the_foot_dorsal_aspect_Primal.png\" class=\"image\"><img loading=\"lazy\" alt=\"\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/2\/25\/Muscles_of_the_foot_dorsal_aspect_Primal.png\/300px-Muscles_of_the_foot_dorsal_aspect_Primal.png\" decoding=\"async\" width=\"300\" height=\"300\" class=\"thumbimage\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/2\/25\/Muscles_of_the_foot_dorsal_aspect_Primal.png\/450px-Muscles_of_the_foot_dorsal_aspect_Primal.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/2\/25\/Muscles_of_the_foot_dorsal_aspect_Primal.png\/600px-Muscles_of_the_foot_dorsal_aspect_Primal.png 2x\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><a href=\"\/File:Muscles_of_the_foot_dorsal_aspect_Primal.png\" class=\"internal\" title=\"Enlarge\"><\/a><\/div>\n<p>Muscles du pied (face dorsale)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<p><b>Tendons extenseurs dorsaux :<\/b><\/p>\n<p>Les tendons du long et du court extenseur de l&rsquo;hallux assurent la stabilit\u00e9 dynamique pendant la flexion plantaire.<\/p>\n<p><b>Bandes sagittales :<\/b><\/p>\n<p>Ces ligaments entourent l&rsquo;articulation m\u00e9tatarsophalangienne. Ils sont adjacents \u00e0 la capsule articulaire et s&rsquo;\u00e9tendent des tendons aux s\u00e9samo\u00efdes. Ils stabilisent et centralisent les tendons extenseurs pendant le mouvement.<\/p>\n<h3><span class=\"mw-headline\" id=\"Range_of_Motion\">L&rsquo;amplitude de mouvement <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=4\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Range of Motion\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=4\" title=\"Edit section: Range of Motion\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>La position de repos normale de la premi\u00e8re articulation m\u00e9tatarsophalangienne par rapport \u00e0 l&rsquo;axe longitudinal du premier m\u00e9tatarsien est de 16 degr\u00e9s de dorsiflexion.<sup id=\"cite_ref-:1_3-1\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<ul>\n<li>Amplitude de mouvement : la flexion plantaire passive est de 3 \u00e0 43 degr\u00e9s et la dorsiflexion passive est comprise entre 40 et 100 degr\u00e9s.<\/li>\n<\/ul>\n<ul>\n<li>Un cycle de marche normal n\u00e9cessite une extension (dorsiflexion) de la 1\u00e8re m\u00e9tatarsophalangienne de 45 \u00e0 60 degr\u00e9s.<\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 508px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 500px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/umCSpwEvWUM?\" width=\"500\" height=\"281\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-6\" class=\"reference\"><a href=\"#cite_note-6\">(6)<\/a><\/sup><\/p>\n<h2><span class=\"mw-headline\" id=\"Function_of_the_Hallux\">Fonction de l&rsquo;hallux <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=5\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Function of the Hallux\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=5\" title=\"Edit section: Function of the Hallux\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;hallux est essentiel au fonctionnement quotidien et aux activit\u00e9s quotidiennes :<sup id=\"cite_ref-:1_3-2\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/p>\n<ol>\n<li>Pendant la phase d&rsquo;appui de la marche, l&rsquo;hallux supporte une charge deux fois sup\u00e9rieure \u00e0 celle des autres orteils et environ 40 \u00e0 60 % du poids du corps.<\/li>\n<li>Lors d&rsquo;une activit\u00e9 dynamique, le gros orteil contribue au mouvement naturel du pied, permettant au corps d&rsquo;avancer dans l&rsquo;espace. Pendant la phase d&rsquo;appui, le poids du corps et les forces de r\u00e9action au sol tendent \u00e0 aplatir l&rsquo;arche longitudinale m\u00e9diane, ce que le m\u00e9canisme du guindeau permet de contrecarrer. <sup id=\"cite_ref-7\" class=\"reference\"><a href=\"#cite_note-7\">(7) <\/a><\/sup><a href=\"\/Windlass_Test\" title=\"Windlass Test\">Cliquez ici pour<\/a> en savoir plus sur le m\u00e9canisme du guindeau.<\/li>\n<li>Le gros orteil joue un r\u00f4le important dans l&rsquo;\u00e9quilibre statique et dynamique. Lorsque le gros orteil est contraint, la performance en appui sur une seule jambe et la capacit\u00e9 de contr\u00f4le directionnel pendant le d\u00e9placement du poids vers l&rsquo;avant ou vers l&rsquo;arri\u00e8re peuvent \u00eatre alt\u00e9r\u00e9es.<sup id=\"cite_ref-8\" class=\"reference\"><a href=\"#cite_note-8\">(8)<\/a><\/sup><\/li>\n<\/ol>\n<h2><span class=\"mw-headline\" id=\"Aetiology\">\u00c9tiologie<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=6\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Aetiology\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=6\" title=\"Edit section: Aetiology\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>La majorit\u00e9 des cas d&rsquo;hallux rigidus sont idiopathiques. Des l\u00e9sions traumatiques ou iatrog\u00e8nes peuvent endommager le cartilage articulaire de l&rsquo;articulation m\u00e9tatarsophalangienne (MTP) et entra\u00eener l&rsquo;apparition d&rsquo;un hallux rigidus. De plus, la pr\u00e9sence des modifications structurelles suivantes pourrait \u00eatre corr\u00e9l\u00e9e au d\u00e9veloppement de l&rsquo;hallux limitus et de l&rsquo;hallux rigidus :<\/p>\n<ul>\n<li>Premier m\u00e9tatarsien en position plus dorsale par rapport au deuxi\u00e8me m\u00e9tatarsien <sup id=\"cite_ref-:5_9-0\" class=\"reference\"><a href=\"#cite_note-:5-9\">(9)<\/a><\/sup><\/li>\n<li>Avant-pied en position de flexion plantaire sur l&rsquo;arri\u00e8re-pied <sup id=\"cite_ref-:5_9-1\" class=\"reference\"><a href=\"#cite_note-:5-9\">(9)<\/a><\/sup><\/li>\n<li>Amplitude de mouvement r\u00e9duite \u00e0 la premi\u00e8re articulation m\u00e9tatarsophalangienne <sup id=\"cite_ref-:5_9-2\" class=\"reference\"><a href=\"#cite_note-:5-9\">(9)<\/a><\/sup><\/li>\n<li>Phalange proximale, phalange distale, s\u00e9samo\u00efde m\u00e9dial et s\u00e9samo\u00efde lat\u00e9ral plus longs. <sup id=\"cite_ref-:5_9-3\" class=\"reference\"><a href=\"#cite_note-:5-9\">(9)<\/a><\/sup><\/li>\n<li>Premier m\u00e9tatarsien et premi\u00e8re phalange proximale plus larges <sup id=\"cite_ref-:5_9-4\" class=\"reference\"><a href=\"#cite_note-:5-9\">(9)<\/a><\/sup><\/li>\n<li>Coughlin et Shurnas <sup id=\"cite_ref-:7_10-0\" class=\"reference\"><a href=\"#cite_note-:7-10\">(10)<\/a><\/sup> ont \u00e9galement signal\u00e9 une association entre l&rsquo;hallux rigidus et une articulation m\u00e9tatarsophalangienne plate ou en chevron, un m\u00e9tatarsus adductus et un hallux valgus interphalangeus.<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"Risk_Factors\">Facteurs de risque <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=7\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Risk Factors\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=7\" title=\"Edit section: Risk Factors\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Selon une \u00e9tude men\u00e9e par Senga et al, <sup id=\"cite_ref-:0_11-0\" class=\"reference\"><a href=\"#cite_note-:0-11\">(11)<\/a><\/sup> l&rsquo;arthrose du genou, l&rsquo;hallux valgus et les \u00e9pisodes de goutte \u00e9taient des facteurs de risque ind\u00e9pendants pour l&rsquo;hallux rigidus<\/li>\n<li>Les ant\u00e9c\u00e9dents familiaux d&rsquo;hallux rigidus sont compatibles avec un hallux rigidus bilat\u00e9ral <sup id=\"cite_ref-:7_10-1\" class=\"reference\"><a href=\"#cite_note-:7-10\">(10)<\/a><\/sup><\/li>\n<li>L&rsquo;hallux rigidus unilat\u00e9ral peut survenir chez les patients ayant des ant\u00e9c\u00e9dents de traumatisme <sup id=\"cite_ref-:7_10-2\" class=\"reference\"><a href=\"#cite_note-:7-10\">(10)<\/a><\/sup><\/li>\n<li>La pr\u00e9valence de l&rsquo;hallux rigidus est plus \u00e9lev\u00e9e chez les adultes plus \u00e2g\u00e9s (\u226550 ans) <sup id=\"cite_ref-:0_11-1\" class=\"reference\"><a href=\"#cite_note-:0-11\">(11)<\/a><\/sup><\/li>\n<li>L&rsquo;hallux rigidus est plus fr\u00e9quent chez les femmes <sup id=\"cite_ref-:6_12-0\" class=\"reference\"><a href=\"#cite_note-:6-12\">(12) <\/a><\/sup><sup id=\"cite_ref-13\" class=\"reference\"><a href=\"#cite_note-13\">(13)<\/a><\/sup><\/li>\n<li>La taille d&rsquo;un individu a un impact sur l&rsquo;hallux rigidus : \u00ab\u00a0plus la taille du patient est \u00e9lev\u00e9e, plus l&rsquo;hallux rigidus se d\u00e9veloppe\u00a0\u00bb <sup id=\"cite_ref-:6_12-1\" class=\"reference\"><a href=\"#cite_note-:6-12\">(12)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Clinical_Presentation\">Pr\u00e9sentation clinique <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=8\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Clinical Presentation\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=8\" title=\"Edit section: Clinical Presentation\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Les personnes atteintes d&rsquo;hallux rigidus pr\u00e9sentent divers <b>signes et sympt\u00f4mes<\/b>, notamment<\/p>\n<ul>\n<li>douleur (une douleur br\u00fblante et une paresth\u00e9sie peuvent \u00eatre pr\u00e9sentes)<\/li>\n<li>gonflement et rougeur de l&rsquo;articulation <sup id=\"cite_ref-:1_3-3\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>rigidit\u00e9<\/li>\n<li>perte de mouvement (absence <i>totale<\/i> de mouvement) <sup id=\"cite_ref-:2_5-1\" class=\"reference\"><a href=\"#cite_note-:2-5\">(5)<\/a><\/sup><\/li>\n<li>r\u00e9duction de l&rsquo;amplitude de la flexion plantaire au niveau de l&rsquo;articulation de la cheville <sup id=\"cite_ref-:3_14-0\" class=\"reference\"><a href=\"#cite_note-:3-14\">(14)<\/a><\/sup><\/li>\n<li>callosit\u00e9s plantaires <sup id=\"cite_ref-:0_11-2\" class=\"reference\"><a href=\"#cite_note-:0-11\">(11)<\/a><\/sup><\/li>\n<li>\u00e9largissement des articulations <sup id=\"cite_ref-:0_11-3\" class=\"reference\"><a href=\"#cite_note-:0-11\">(11)<\/a><\/sup><\/li>\n<\/ul>\n<p>Les <b>limitations fonctionnelles<\/b> suivantes aussi peuvent \u00eatre pr\u00e9sentes :<\/p>\n<ul>\n<li>douleur accrue lors de la marche, de la course ou de l&rsquo;accroupissement<\/li>\n<li>d\u00e9marche antalgique : <sup id=\"cite_ref-:1_3-4\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup>\n<ul>\n<li>diminution de la pouss\u00e9e des orteils lors de la phase pr\u00e9-oscillationde la marche<\/li>\n<li>raccourcissement de la longueur du cycle de marche ou du pas<\/li>\n<li>adaptations compensatoires incluant :\n<ul>\n<li>une rotation externe de la hanche ipsilat\u00e9rale<\/li>\n<li>une \u00e9l\u00e9vation et circumduction de la hanche permettent \u00e0 la pointe du pied concern\u00e9 de d\u00e9gager le sol pendant la phase d&rsquo;oscillation de la marche<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>augmentation de la mise en charge sur l&rsquo;avant-pied lat\u00e9rale <sup id=\"cite_ref-:3_14-1\" class=\"reference\"><a href=\"#cite_note-:3-14\">(14)<\/a><\/sup> <sup id=\"cite_ref-15\" class=\"reference\"><a href=\"#cite_note-15\">(15) <\/a><\/sup>(usure in\u00e9gale de la chaussure avec signes d&rsquo;usure accrue sous la MTP-2 et l&rsquo;avant-pied lat\u00e9ral)<\/li>\n<li>diminution de l&rsquo;excursion totale de l&rsquo;articulation de la cheville pendant la marche en palier <sup id=\"cite_ref-:3_14-2\" class=\"reference\"><a href=\"#cite_note-:3-14\">(14)<\/a><\/sup><\/li>\n<li>augmentation de la supination de l&rsquo;avant-pied lors de la pouss\u00e9e <sup id=\"cite_ref-16\" class=\"reference\"><a href=\"#cite_note-16\">(16)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Diagnostic_Procedures\">Proc\u00e9dures de diagnostic <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=9\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Diagnostic Procedures\">modifier<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=9\" title=\"Edit section: Diagnostic Procedures\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span class=\"mw-headline\" id=\"Radiograph\">Radiographie<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=10\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Radiograph\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=10\" title=\"Edit section: Radiograph\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<div class=\"floatright\"><a href=\"\/File:Hallux_rigidus_XR.jpg\" class=\"image\"><img loading=\"lazy\" alt=\"Hallux rigidus XR.jpg\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/96\/Hallux_rigidus_XR.jpg\/350px-Hallux_rigidus_XR.jpg\" decoding=\"async\" width=\"350\" height=\"407\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/9\/96\/Hallux_rigidus_XR.jpg\/525px-Hallux_rigidus_XR.jpg 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/9\/96\/Hallux_rigidus_XR.jpg\/700px-Hallux_rigidus_XR.jpg 2x\"><\/a><\/div>\n<p>Des radiographies en mise en charge, ant\u00e9ro-post\u00e9rieure et lat\u00e9rale sont g\u00e9n\u00e9ralement n\u00e9cessaires pour examiner l&rsquo;articulation. <sup id=\"cite_ref-17\" class=\"reference\"><a href=\"#cite_note-17\">(17)<\/a><\/sup> On observe souvent un r\u00e9tr\u00e9cissement non uniforme de l&rsquo;interligne articulaire et un \u00e9largissement ou un aplatissement de la t\u00eate du premier m\u00e9tatarsien. On peut observer une scl\u00e9rose sous-chondrale, des kystes sous-chondraux, des ost\u00e9ophytes en forme de fer \u00e0 cheval sur la face dorsale et des ost\u00e9ophytes sur les bords des articulations. <sup id=\"cite_ref-:11_1-1\" class=\"reference\"><a href=\"#cite_note-:11-1\">(1)<\/a><\/sup> De plus, une hypertrophie des s\u00e9samo\u00efdes peut \u00eatre pr\u00e9sente.<\/p>\n<h3><span class=\"mw-headline\" id=\"Classification_Systems_for_Hallux_Rigidus\">Les syst\u00e8mes de classification de l&rsquo;hallux rigidus <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=11\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Classification Systems for Hallux Rigidus\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=11\" title=\"Edit section: Classification Systems for Hallux Rigidus\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<h4><span id=\"Regnauld_Classification(18)\"><\/span><span class=\"mw-headline\" id=\"Regnauld_Classification.5B18.5D\">Classification de Regnauld <sup id=\"cite_ref-:4_18-0\" class=\"reference\"><a href=\"#cite_note-:4-18\">(18) <\/a><\/sup><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=12\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Regnauld Classification(18)\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=12\" title=\"Edit section: Regnauld Classification(18)\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Un syst\u00e8me de classification clinique et radiographique d\u00e9crit par Regnauld appara\u00eet principalement dans la litt\u00e9rature europ\u00e9enne :<\/p>\n<ul>\n<li>Grade I : hallux limitus fonctionnel<\/li>\n<li>Grade II : adaptation de l&rsquo;articulation avec aplatissement de la t\u00eate du premier m\u00e9tatarsien et douleur \u00e0 la fin de l&rsquo;amplitude de mouvement<\/li>\n<li>Grade III : arthrose avec aplatissement s\u00e9v\u00e8re de la t\u00eate du premier m\u00e9tatarsien, ost\u00e9ophytes, r\u00e9tr\u00e9cissement asym\u00e9trique de l&rsquo;interligne articulaire et \u00e9rosions<\/li>\n<\/ul>\n<div class=\"center\">\n<div class=\"thumb tnone\">\n<div class=\"thumbinner\" style=\"width:352px;\"><a href=\"\/File:Severity_of_hallux_rigidus.png\" class=\"image\"><img loading=\"lazy\" alt=\"\" src=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/1b\/Severity_of_hallux_rigidus.png\/350px-Severity_of_hallux_rigidus.png\" decoding=\"async\" width=\"350\" height=\"133\" class=\"thumbimage\" srcset=\"https:\/\/www.physio-pedia.com\/images\/thumb\/1\/1b\/Severity_of_hallux_rigidus.png\/525px-Severity_of_hallux_rigidus.png 1.5x, https:\/\/www.physio-pedia.com\/images\/thumb\/1\/1b\/Severity_of_hallux_rigidus.png\/700px-Severity_of_hallux_rigidus.png 2x\"><\/a><\/p>\n<div class=\"thumbcaption\">\n<div class=\"magnify\"><a href=\"\/File:Severity_of_hallux_rigidus.png\" class=\"internal\" title=\"Enlarge\"><\/a><\/div>\n<p><small>Version modifi\u00e9e de la classification de Hattrup et Johnson. Adapt\u00e9 de Senga Y, Nishimura A, Ito N, Kitaura Y, Sudo A<i>.<\/i> <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-021-04666-y#citeas\">Prevalence of and risk factors for hallux rigidus : a cross-sectional study in Japan<\/a>. BMC Musculoskelet Disord 2021 ; 22 (786).<\/small><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h4><span id=\"Hattrup_and_Johnson_Classification(19)(18)\"><\/span><span class=\"mw-headline\" id=\"Hattrup_and_Johnson_Classification.5B19.5D.5B18.5D\">Classification de Hattrup et Johnson <sup id=\"cite_ref-Hattrup_and_Johnson_19-0\" class=\"reference\"><a href=\"#cite_note-Hattrup_and_Johnson-19\">(19) <\/a><\/sup><sup id=\"cite_ref-:4_18-1\" class=\"reference\"><a href=\"#cite_note-:4-18\">(18)<\/a><\/sup><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=13\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Hattrup and Johnson Classification(19)(18)\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=13\" title=\"Edit section: Hattrup and Johnson Classification(19)(18)\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Grade I: formation l\u00e9g\u00e8re \u00e0 mod\u00e9r\u00e9e d&rsquo;ost\u00e9ophytes sans atteinte articulaire<\/li>\n<li>Grade II : formation mod\u00e9r\u00e9e d&rsquo;ost\u00e9ophytes, r\u00e9tr\u00e9cissement de l&rsquo;espace articulaire et scl\u00e9rose sous-chondrale<\/li>\n<li>Grade III : formation accrue d&rsquo;ost\u00e9ophytes et perte de l&rsquo;espace articulaire<\/li>\n<\/ul>\n<h4><span class=\"mw-headline\" id=\"Coughlin_and_Shurnass_Classification\">Classification de Coughlin et Shurnass <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=14\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Coughlin and Shurnass Classification\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=14\" title=\"Edit section: Coughlin and Shurnass Classification\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<p>Coughlin et al. <sup id=\"cite_ref-20\" class=\"reference\"><a href=\"#cite_note-20\">(20)<\/a><\/sup> ont modifi\u00e9 la classification de Hattrup et Johnson pour cr\u00e9er la classification de Coughlin et Shurnass <sup id=\"cite_ref-:7_10-3\" class=\"reference\"><a href=\"#cite_note-:7-10\">(10)<\/a><\/sup> :<\/p>\n<ul>\n<li>Grade 0 : Dorsiflexion 40 \u00e0 60\u00b0, radiographie normale, absence de douleur<\/li>\n<li>Grade 1 : Dorsiflexion 30 \u00e0 40\u00b0, ost\u00e9ophytes sur la face dorsale, minimes ou aucune autre modification de l&rsquo;articulation<\/li>\n<li>Grade 2 : Dorsiflexion 10 \u00e0 30\u00b0, r\u00e9tr\u00e9cissement ou scl\u00e9rose l\u00e9g\u00e8re \u00e0 mod\u00e9r\u00e9e de l&rsquo;articulation, ost\u00e9ophytes<\/li>\n<li>Grade 3 : Dorsiflexion inf\u00e9rieure \u00e0 10\u00b0, modifications radiographiques s\u00e9v\u00e8res, douleur constante mod\u00e9r\u00e9e \u00e0 s\u00e9v\u00e8re aux extr\u00e9mit\u00e9s<\/li>\n<li>Grade 4 : Articulation raide, modifications s\u00e9v\u00e8res avec corps d\u00e9tach\u00e9s et ost\u00e9ochondrite diss\u00e9quante<\/li>\n<\/ul>\n<h4><span id=\"Roukis_Classification(18)\"><\/span><span class=\"mw-headline\" id=\"Roukis_Classification.5B18.5D\">Classification de Roukis <sup id=\"cite_ref-:4_18-2\" class=\"reference\"><a href=\"#cite_note-:4-18\">(18) <\/a><\/sup><\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=15\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Roukis Classification(18)\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=15\" title=\"Edit section: Roukis Classification(18)\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h4>\n<ul>\n<li>Grade 1 : Premier m\u00e9tatarsion sur\u00e9lev\u00e9, scl\u00e9rose sous-chondrale p\u00e9riarticulaire, exostose dorsale minime et aplatissement minime de la t\u00eate m\u00e9tatarsienne<\/li>\n<li>Grade 2 : exostose dorsale mod\u00e9r\u00e9e, aplatissement de la t\u00eate m\u00e9tatarsienne, r\u00e9tr\u00e9cissement minime de l&rsquo;interligne articulaire, hypertrophie des s\u00e9samo\u00efdes<\/li>\n<li>Grade 3 : exostose dorsale s\u00e9v\u00e8re, r\u00e9tr\u00e9cissement focal de l&rsquo;espace articulaire, formation de kystes, corps \u00e9trangers.<\/li>\n<li>Grade 4 : exostose excessive de la t\u00eate m\u00e9tatarsienne et de la base de la phalange proximale, absence d&rsquo;espace articulaire, ankylose.<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Examination\">\u00c9valuation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=16\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Examination\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=16\" title=\"Edit section: Examination\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;examen physique du patient souffrant d&rsquo;hallux rigidus doit comprendre les \u00e9l\u00e9ments suivants :<\/p>\n<ul>\n<li>Observation : les ost\u00e9ophytes peuvent \u00eatre visualis\u00e9s et palp\u00e9s, la forme du pied et l&rsquo;alignement du gros orteil peuvent \u00eatre not\u00e9s. Le mauvais alignement du gros orteil peut inclure l&rsquo;hyperextension de la premi\u00e8re articulation interphalangienne (IP) et la rotation du gros orteil vers l&rsquo;orteil adjacent. La forme du pied peut \u00eatre affect\u00e9e par l&rsquo;enflure, la formation de callosit\u00e9s sur la plante du pied et l&rsquo;augmentation de la mise en charge sur la face lat\u00e9rale du pied.<\/li>\n<li>Palpation : une sensibilit\u00e9 peut \u00eatre pr\u00e9sente au niveau de la face dorsale de l&rsquo;articulation. La dorsiflexion extr\u00eame peut provoquer une douleur due \u00e0 un conflit avec des ost\u00e9ophytes sur la face dorsale. De plus, la traction du tendon du long extenseur der l&rsquo;hallux sur les ost\u00e9ophytes dorsaux pendant la flexion plantaire peut provoquer des douleurs.<\/li>\n<li>Une compression de la premi\u00e8re articulation MTP \u00ab\u00a0grind testing\u00a0\u00bb positif indique une arthrite plus avanc\u00e9e. Une douleur dans l&rsquo;amplitude moyenne des mouvements peut \u00e9galement indiquer une progression de l&rsquo;arthrite. Les patients peuvent pr\u00e9senter une hyperextension de la premi\u00e8re articulation IP en r\u00e9action \u00e0 une dorsiflexion limit\u00e9e de la premi\u00e8re MTP.<sup id=\"cite_ref-21\" class=\"reference\"><a href=\"#cite_note-21\">(21)<\/a><\/sup><\/li>\n<li>\u00c9valuation de l&rsquo;amplitude de mouvement : amplitude des mouvements de dorsiflexion et de flexion plantaire de la cheville. Dans les cas d&rsquo;arthrite avanc\u00e9e, les patients font \u00e9tat d&rsquo;une douleur dans l&rsquo;amplitude moyenne. Le degr\u00e9 de rigidit\u00e9 peut \u00eatre d\u00e9fini par la douleur pr\u00e9sente lors de la dorsiflexion, de flexion plantaire ou dans toute l&rsquo;amplitude de mouvement.<\/li>\n<\/ul>\n<p><b>Test d&rsquo;extension de l&rsquo;articulation MTP-1 :<\/b><\/p>\n<ul>\n<li>Test passif : Le patient est en position debout, le genou fl\u00e9chi : soulever passivement son gros orteil. Mesurer l&rsquo;extension (dorsifflexion) de l&rsquo;orteil. <b>Revenir \u00e0 la position de d\u00e9part<\/b>. Effectuez ensuite une rotation externe manuelle du tibia \u00e0 l&rsquo;aide des muscles du mollet. Cela permet \u00e0 l&rsquo;articulation sous-talienne de se placer en supination et ainsi d&rsquo;augmenter la hauteur de l&rsquo;arc longitudinal m\u00e9dian. Soulever passivement le gros orteil. Mesurer l&rsquo;extension (dorsiflexion) de l&rsquo;orteil. La <b>diff\u00e9rence entre les deux mesures<\/b> peut \u00eatre due \u00e0 la diminution de la tension sur le fascia plantaire, ce qui permet au gros orteil de lever davantage.<\/li>\n<li>Test actif : Le patient est en position debout. Stabiliser la phalange au sol et amener le m\u00eame genou en flexion et la cheville en flexion plantaire. Il en r\u00e9sulte une extension de l&rsquo;articulation MTP.<sup id=\"cite_ref-:3_14-3\" class=\"reference\"><a href=\"#cite_note-:3-14\">(14)<\/a><\/sup><\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Non-Surgical_Management\">Traitement non chirurgical <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=17\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Non-Surgical Management\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=17\" title=\"Edit section: Non-Surgical Management\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<h3><span class=\"mw-headline\" id=\"Pharmacology\">Pharmacologie<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=18\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Pharmacology\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=18\" title=\"Edit section: Pharmacology\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<ul>\n<li>Le traitement des cas l\u00e9gers ou mod\u00e9r\u00e9s d&rsquo;hallux rigidus inclut souvent des <b>anti-inflammatoires non st\u00e9ro\u00efdiens (AINS)<\/b>, qui soulagent g\u00e9n\u00e9ralement certains sympt\u00f4mes.<\/li>\n<\/ul>\n<ul>\n<li>Les <b>injections de cortisone<\/b> apportent un soulagement dans les 24 heures mais qui n&rsquo;est souvent que temporaire (jusqu&rsquo;\u00e0 trois mois). <sup id=\"cite_ref-:8_22-0\" class=\"reference\"><a href=\"#cite_note-:8-22\">(22) <\/a><\/sup><sup id=\"cite_ref-23\" class=\"reference\"><a href=\"#cite_note-23\">(23)<\/a><\/sup><\/li>\n<li>L&rsquo;injection intra-articulaire de <b>hyaluronate de sodium<\/b> entra\u00eene une \u00ab\u00a0diminution de la douleur et une am\u00e9lioration de la fonction trois mois apr\u00e8s l&rsquo;injection\u00a0\u00bb. <sup id=\"cite_ref-24\" class=\"reference\"><a href=\"#cite_note-24\">(24) <\/a><\/sup><sup id=\"cite_ref-:10_25-0\" class=\"reference\"><a href=\"#cite_note-:10-25\">(25)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span id=\"Footwear,_Insoles_and_Orthotics\"><\/span><span class=\"mw-headline\" id=\"Footwear.2C_Insoles_and_Orthotics\">Chaussures, semelles et orth\u00e8ses <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=19\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Footwear, Insoles and Orthotics\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=19\" title=\"Edit section: Footwear, Insoles and Orthotics\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Objectif : bloquer ou prot\u00e9ger l&rsquo;hallux du mouvement de dorsiflexion au niveau de la premi\u00e8re MTP.<\/p>\n<p>Les modifications de chaussures suivantes sont des recommandations de grade C :<\/p>\n<ul>\n<li>Des semelles rigides avec barre rigide ou des chaussures \u00e0 semelles berceau. Les semelles berceau peuvent \u00eatre appropri\u00e9es pour d\u00e9charger le moment d&rsquo;extension de la MTP-1 pendant la phase de d\u00e9collement des orteils de la marche. <sup id=\"cite_ref-:1_3-5\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Des chaussures \u00e0 semelle rigide ou des semelles en graphite peuvent contribuer \u00e0 r\u00e9duire le moment d&rsquo;extension au niveau de l&rsquo;articulation MTP-1. <sup id=\"cite_ref-:1_3-6\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Porter des chaussures avec une grande empeigne et cesser le port de talons hauts. <sup id=\"cite_ref-26\" class=\"reference\"><a href=\"#cite_note-26\">(26)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"row\">\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/5tR7VSjgUEs?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-27\" class=\"reference\"><a href=\"#cite_note-27\">(27)<\/a><\/sup><\/div>\n<\/div>\n<div class=\"col-md-6\">\n<div class=\"thumb embedvideo autoResize\" style=\"width: 258px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 250px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/3mbI9qMEW6o?\" width=\"250\" height=\"141\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"text-right\"><sup id=\"cite_ref-28\" class=\"reference\"><a href=\"#cite_note-28\">(28)<\/a><\/sup><\/div>\n<\/div>\n<\/div>\n<h3><span class=\"mw-headline\" id=\"Manual_Techniques\">Techniques manuelles <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=20\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Manual Techniques\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=20\" title=\"Edit section: Manual Techniques\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Objectifs :<\/p>\n<ol>\n<li>Maintenir la mobilit\u00e9 de l&rsquo;articulation talo-crurale afin de pr\u00e9server la fonction<\/li>\n<li>Diminuer la douleur par la compression<\/li>\n<li>Pr\u00e9server et augmenter la flexion plantaire et la dorsiflexion \u00e0 la MTP-1<\/li>\n<\/ol>\n<p>Les techniques suivantes sont recommand\u00e9es (niveau de preuve C)<\/p>\n<ul>\n<li>Distraction de la 1\u00e8re MTP, seule ou avec des glissements dorsaux et plantaires <sup id=\"cite_ref-:1_3-7\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Mobilisations articulaires de grade III sur les 2 os s\u00e9samo\u00efdes de la premi\u00e8re MTP affect\u00e9e <sup id=\"cite_ref-:9_29-0\" class=\"reference\"><a href=\"#cite_note-:9-29\">(29) <\/a><\/sup><sup id=\"cite_ref-30\" class=\"reference\"><a href=\"#cite_note-30\">(30)<\/a><\/sup><\/li>\n<\/ul>\n<div class=\"thumb embedvideo autoResize\" style=\"width: 308px;\">\n<div class=\"embedvideo autoResize\" style=\"\">\n<div class=\"embedvideowrap\" style=\"width: 300px;\"><iframe loading=\"lazy\" title=\"Play video\" src=\"\/\/www.youtube.com\/embed\/ZOur5I0RTVo?\" width=\"300\" height=\"169\" frameborder=\"0\" allowfullscreen=\"true\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<p><sup id=\"cite_ref-31\" class=\"reference\"><a href=\"#cite_note-31\">(31)<\/a><\/sup><\/p>\n<h3><span class=\"mw-headline\" id=\"Stretching_and_Strengthening\">\u00c9tirements et renforcement <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=21\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Stretching and Strengthening\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=21\" title=\"Edit section: Stretching and Strengthening\">\u00e9diter la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Objectif : am\u00e9liorer la stabilit\u00e9 de la premi\u00e8re MTP<\/p>\n<ul>\n<li>Contractions isom\u00e9triques des muscles long fl\u00e9chisseur de l&rsquo;hallux et maintenir 10 secondes <sup id=\"cite_ref-:9_29-1\" class=\"reference\"><a href=\"#cite_note-:9-29\">(29)<\/a><\/sup><\/li>\n<li>Renforcement isotonique du long fl\u00e9chisseur de l&rsquo;hallux avec r\u00e9sistance manuelle ou bandes \u00e9lastiques <sup id=\"cite_ref-:9_29-2\" class=\"reference\"><a href=\"#cite_note-:9-29\">(29) <\/a><\/sup><sup id=\"cite_ref-:1_3-8\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Renforcement des muscles intrins\u00e8ques plantaires <sup id=\"cite_ref-:1_3-9\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Etirements des gastrocn\u00e9miens et du sol\u00e9aire <sup id=\"cite_ref-:1_3-10\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Exercices de type excursion en \u00e9toile <sup id=\"cite_ref-:1_3-11\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Exercices d&rsquo;\u00e9quilibre sur une jambe &#8211; passer de la position debout sur une surface dure \u00e0 la position debout sur la planche \u00e0 bascule ou le BOSU <sup id=\"cite_ref-:1_3-12\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"Conditioning\">Conditionnement<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=22\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Conditioning\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=22\" title=\"Edit section: Conditioning\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Objectif : am\u00e9liorer l&rsquo;endurance<\/p>\n<ul>\n<li>Cyclisme en position d\u00e9cubitus <sup id=\"cite_ref-:1_3-13\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/li>\n<li>Th\u00e9rapie aquatique <sup id=\"cite_ref-:1_3-14\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup>\n<ul>\n<li>Se tenir debout dans l&rsquo;eau jusqu&rsquo;\u00e0 la poitrine pour diminuer la mise en charger sur les pieds<\/li>\n<li>La pression hydrostatique favorise le retour du sang vers le c\u0153ur<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"Activity_Modification\">Modification des activit\u00e9s <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=23\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Activity Modification\">modifier<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=23\" title=\"Edit section: Activity Modification\">modifier la source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>Les coureurs souffrant d&rsquo;hallux rigidus de stade II ou plus peuvent avoir besoin de : <sup id=\"cite_ref-:1_3-15\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup><\/p>\n<ul>\n<li>passer \u00e0 des randonn\u00e9es l\u00e9g\u00e8res d&rsquo;une journ\u00e9e<\/li>\n<li>passer de l&rsquo;asphalte aux sentiers en terre battue pour les courses de longue dur\u00e9e<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"Surgical_therapy\">Traitement chirurgical <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=24\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Surgical therapy\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=24\" title=\"Edit section: Surgical therapy\">edit source<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h3>\n<p>L&rsquo;indication de la chirurgie est une douleur intraitable isol\u00e9e \u00e0 la premi\u00e8re articulation m\u00e9tatarsophalangienne qui ne s&rsquo;am\u00e9liore pas avec la modification de la chaussure, les semelles rigides, les anti-inflammatoires non st\u00e9ro\u00efdiens et la modification des activit\u00e9s. Le choix d\u00e9pend du stade de l&rsquo;atteinte, des limitations de l&rsquo;amplitude de mouvement, du niveau d&rsquo;activit\u00e9 du patient et des pr\u00e9f\u00e9rences du chirurgien et du patient.<\/p>\n<p>Les types de chirurgie sont les suivants :<\/p>\n<ul>\n<li><b>Cheilectomie.<\/b> Le traitement des stades pr\u00e9coces de l&rsquo;hallux rigidus inclut la r\u00e9section de &lt; 30 % de la face dorsale de la t\u00eate m\u00e9tatarsienne et l&rsquo;ablation des \u00e9perons osseux au sommet de l&rsquo;articulation. G\u00e9n\u00e9ralement b\u00e9n\u00e9fique pour les maladies l\u00e9g\u00e8res \u00e0 mod\u00e9r\u00e9es avec moins de 50 % de l&rsquo;articulation touch\u00e9e, g\u00e9n\u00e9ralement de grade 1 et de grade 2. <sup id=\"cite_ref-Mann_and_Clanton_32-0\" class=\"reference\"><a href=\"#cite_note-Mann_and_Clanton-32\">(32) <\/a><\/sup><sup id=\"cite_ref-Hattrup_and_Johnson_19-1\" class=\"reference\"><a href=\"#cite_note-Hattrup_and_Johnson-19\">(19) <\/a><\/sup><sup id=\"cite_ref-33\" class=\"reference\"><a href=\"#cite_note-33\">(33) <\/a><\/sup><sup id=\"cite_ref-Coughlin_34-0\" class=\"reference\"><a href=\"#cite_note-Coughlin-34\">(34) <\/a><\/sup><sup id=\"cite_ref-:10_25-1\" class=\"reference\"><a href=\"#cite_note-:10-25\">(25)<\/a><\/sup><\/li>\n<\/ul>\n<ul>\n<li><b>Ost\u00e9otomie de dorsiflexion de la phalange (ost\u00e9otomie de Moberg). <\/b>Chez les patients ayant une amplitude de mouvement raisonnable, une ost\u00e9otomie du coin dorsal de la phalange augmente la dorsiflexion au prix th\u00e9orique d&rsquo;une perte de la flexion plantaire. Elle est g\u00e9n\u00e9ralement r\u00e9alis\u00e9e en m\u00eame temps qu&rsquo;une ch\u00e9ilectomie. <sup id=\"cite_ref-:8_22-1\" class=\"reference\"><a href=\"#cite_note-:8-22\">(22)<\/a><\/sup> Les cas l\u00e9gers \u00e0 mod\u00e9r\u00e9s n\u00e9cessitent parfois cette intervention.<\/li>\n<\/ul>\n<ul>\n<li><b>Arthroplastie d&rsquo;excision ou proc\u00e9dure de Keller. <\/b><sup id=\"cite_ref-Mann_and_Clanton_32-1\" class=\"reference\"><a href=\"#cite_note-Mann_and_Clanton-32\">(32) <\/a><\/sup><sup id=\"cite_ref-35\" class=\"reference\"><a href=\"#cite_note-35\">(35)<\/a><\/sup><b> <\/b> Dans l&rsquo;intervention de Keller, la base de la phalange proximale est r\u00e9s\u00e9qu\u00e9e et une reconstruction des tissus mous est effectu\u00e9e pour d\u00e9comprimer l&rsquo;articulation, diminuer la douleur et am\u00e9liorer l&rsquo;amplitude de mouvement. La proc\u00e9dure de Keller peut entra\u00eener une faiblesse du gros orteil, une d\u00e9formation de type \u00ab\u00a0cock-up\u00a0\u00bb et une m\u00e9tatarsalgie.<sup id=\"cite_ref-36\" class=\"reference\"><a href=\"#cite_note-36\">(36)<\/a><\/sup><\/li>\n<\/ul>\n<ul>\n<li><b>Arthrod\u00e8se de la MTP. <\/b>Intervention visant \u00e0 fusionner les surfaces articulaires. <sup id=\"cite_ref-37\" class=\"reference\"><a href=\"#cite_note-37\">(37)<\/a><\/sup> Il s&rsquo;agit d&rsquo;une chirurgie de r\u00e9f\u00e9rence pour l&rsquo;hallux rigidus en phase terminale, <sup id=\"cite_ref-:1_3-16\" class=\"reference\"><a href=\"#cite_note-:1-3\">(3)<\/a><\/sup> <sup id=\"cite_ref-Coughlin_34-1\" class=\"reference\"><a href=\"#cite_note-Coughlin-34\">(34)<\/a><\/sup> et elle est recommand\u00e9e lorsque d&rsquo;autres interventions ont \u00e9chou\u00e9 (par exemple, l&rsquo;intervention ou proc\u00e9dure de Keller). L&rsquo;arthrod\u00e8se de la premi\u00e8re MTP pr\u00e9sente syst\u00e9matiquement des r\u00e9sultats sup\u00e9rieurs et une plus grande satisfaction des patients par rapport \u00e0 d&rsquo;autres options chirurgicales. Si la cheilectomie peut \u00eatre b\u00e9n\u00e9fique aux premiers stades de l&rsquo;hallux rigidus, l&rsquo;arthrod\u00e8se de la premi\u00e8re MTP semble \u00eatre la meilleure option pour soulager les sympt\u00f4mes de l&rsquo;hallux rigidus aux stades III et IV chez les patients actifs et sportifs.<sup id=\"cite_ref-38\" class=\"reference\"><a href=\"#cite_note-38\">(38)<\/a><\/sup><\/li>\n<\/ul>\n<ul>\n<li><b>Remplacement par une articulation artificielle.<\/b> Proc\u00e9dure visant \u00e0 remplacer les surfaces articulaires par une surface en plastique ou en m\u00e9tal. Cette technique d&rsquo;arthroplastie d&rsquo;interposition des tissus mous procure un excellent soulagement de la douleur et une fonction fiable de l&rsquo;hallux. Elle constitue une alternative \u00e0 l&rsquo;arthrod\u00e8se de la MTP dans certains cas d&rsquo;hallux rigidus s\u00e9v\u00e8re.<sup id=\"cite_ref-39\" class=\"reference\"><a href=\"#cite_note-39\">(39)<\/a><\/sup> L&rsquo;inconv\u00e9nient est que cette nouvelle surface articulaire peut ne pas durer toute la vie, et il n&rsquo;existe actuellement aucune \u00e9tude documentant les performances \u00e0 long terme d&rsquo;une proth\u00e8se de la premi\u00e8re articulation MTP chez les athl\u00e8tes de course \u00e0 pied.<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Differential_Diagnosis\">Diagnostic diff\u00e9rentiel <\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=25\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Differential Diagnosis\">\u00e9diter<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=25\" title=\"Edit section: Differential Diagnosis\">source d&rsquo;\u00e9dition<\/a> <span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>L&rsquo;<a href=\"\/Turf_toe\" title=\"Turf toe\">entorse du gros orteil<\/a>, la fracture, la <a href=\"\/Gout\" title=\"Gout\">goutte<\/a>, la <a href=\"\/Rheumatoid_Arthritis\" title=\"Rheumatoid Arthritis\">polyarthrite rhumato\u00efde<\/a> peuvent \u00eatre d&rsquo;autres causes de douleur et de raideur au niveau de la premi\u00e8re articulation MTP.<\/p>\n<h2><span class=\"mw-headline\" id=\"Resources\">Ressources<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=26\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Resources\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=26\" title=\"Edit section: Resources\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<p>Richie D. How To Treat Hallux Rigidus In Runners. 4 April 2009. Disponible \u00e0 l&rsquo;adresse suivante : <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.hmpgloballearningnetwork.com\/site\/podiatry\/how-to-treat-hallux-rigidus-in-runners\">https:\/\/www.hmpgloballearningnetwork.com\/site\/podiatry\/how-to-treat-hallux-rigidus-in-runners<\/a><\/p>\n<p>Foot and Ankle Center of Washington, Seattle. Disponible \u00e0 l&rsquo;adresse suivante <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.footankle.com\/hallux-rigidus\/\">: https:\/\/www.footankle.com\/hallux-rigidus\/<\/a><\/p>\n<h2><span class=\"mw-headline\" id=\"References\">R\u00e9f\u00e9rences<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">(<\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;veaction=edit&amp;section=27\" class=\"mw-editsection-visualeditor\" title=\"Edit section: References\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Hallux_Rigidus&amp;action=edit&amp;section=27\" title=\"Edit section: References\">edit source<\/a><span class=\"mw-editsection-bracket\">)<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap mw-references-columns\">\n<ol class=\"references\">\n<li id=\"cite_note-:11-1\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:11_1-0\">1.0<\/a><\/sup> <sup><a href=\"#cite_ref-:11_1-1\">1.1<\/a><\/sup><\/span> <span class=\"reference-text\">Patel J, Swords M. Hallux Rigidus. (Updated 2022 Sep 12). In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556019\/\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556019\/<\/a><\/span><\/li>\n<li id=\"cite_note-2\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-2\">\u2191<\/a><\/span> <span class=\"reference-text\">Massimi S, Caravelli S, Fuiano M, Pungetti C, Mosca M, Zaffagnini S. Management of high-grade hallux rigidus: a narrative literature review. Musculoskeletal Surgery. 2020 Dec;104:237-43.<\/span><\/li>\n<li id=\"cite_note-:1-3\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:1_3-0\">3.00<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-1\">3.01<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-2\">3.02<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-3\">3.03<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-4\">3.04<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-5\">3.05<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-6\">3.06<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-7\">3.07<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-8\">3.08<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-9\">3.09<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-10\">3.10<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-11\">3.11<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-12\">3.12<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-13\">3.13<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-14\">3.14<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-15\">3.15<\/a><\/sup> <sup><a href=\"#cite_ref-:1_3-16\">3.16<\/a><\/sup><\/span> <span class=\"reference-text\">Finch R. Hallux Rigidus. Plus Course 2023<\/span><\/li>\n<li id=\"cite_note-4\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-4\">\u2191<\/a><\/span> <span class=\"reference-text\">Hallinan JTPD, Statum SM, Huang BK, Bezerra HG, Garcia DAL, Bydder GM, Chung CB. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/pubs.rsna.org\/doi\/epdf\/10.1148\/rg.2020190145\">High-Resolution MRI of the First Metatarsophalangeal Joint: Gross Anatomy and Injury Characterization<\/a>. Radiographics. 2020 Jul-Aug;40(4):1107-1124. <\/span><\/li>\n<li id=\"cite_note-:2-5\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:2_5-0\">5.0<\/a><\/sup> <sup><a href=\"#cite_ref-:2_5-1\">5.1<\/a><\/sup><\/span> <span class=\"reference-text\">Col\u00f2 G, Fusini F, Zoccola K, Rava A, Samaila EM, Magnan B. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8420823\/pdf\/ACTA-92-10.pdf\">May footwear be a predisposing factor for the development of hallux rigidus? A review of recent findings.<\/a> Acta Biomed. 2021 Jul 26;92(S3):e2021010. <\/span><\/li>\n<li id=\"cite_note-6\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-6\">\u2191<\/a><\/span> <span class=\"reference-text\"> SLO Motion Shoes. Hallux Rigidus: Causes, Diagnosis, and Treatment. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"http:\/\/www.youtube.com\/watch?v=umCSpwEvWUM\">http:\/\/www.youtube.com\/watch?v=umCSpwEvWUM<\/a> (last accessed 06\/01\/17)<\/span><\/li>\n<li id=\"cite_note-7\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-7\">\u2191<\/a><\/span> <span class=\"reference-text\">Williams LR, Ridge ST, Johnson AW, Arch ES, Bruening DA. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/jfootankleres.biomedcentral.com\/articles\/10.1186\/s13047-022-00520-z\">The influence of the windlass mechanism on kinematic and kinetic foot joint coupling.<\/a> J Foot Ankle Res. 2022 Feb 16;15(1):16.<\/span> <\/li>\n<li id=\"cite_note-8\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-8\">\u2191<\/a><\/span> <span class=\"reference-text\">Chou SW, Cheng HY, Chen JH, Ju YY, Lin YC, Wong MK. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/onlinelibrary.wiley.com\/doi\/epdf\/10.1002\/jor.20661\">The role of the great toe in balance performance<\/a>. J Orthop Res. 2009 Apr;27(4):549-54. <\/span><\/li>\n<li id=\"cite_note-:5-9\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:5_9-0\">9.0<\/a><\/sup> <sup><a href=\"#cite_ref-:5_9-1\">9.1<\/a><\/sup> <sup><a href=\"#cite_ref-:5_9-2\">9.2<\/a><\/sup> <sup><a href=\"#cite_ref-:5_9-3\">9.3<\/a><\/sup> <sup><a href=\"#cite_ref-:5_9-4\">9.4<\/a><\/sup><\/span> <span class=\"reference-text\">Zammit GV, Menz HB, Munteanu SE. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.jospt.org\/doi\/epdf\/10.2519\/jospt.2009.3003\">Structural factors associated with hallux limitus\/rigidus: a systematic review of case-control studies.<\/a> J Orthop Sports Phys Ther. 2009 Oct;39(10):733-42. <\/span><\/li>\n<li id=\"cite_note-:7-10\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:7_10-0\">10.0<\/a><\/sup> <sup><a href=\"#cite_ref-:7_10-1\">10.1<\/a><\/sup> <sup><a href=\"#cite_ref-:7_10-2\">10.2<\/a><\/sup> <sup><a href=\"#cite_ref-:7_10-3\">10.3<\/a><\/sup><\/span> <span class=\"reference-text\">Coughlin MJ, Shurnas PS. Hallux rigidus: demographics, aetiology, and radiographic assessment. Foot &amp; ankle international. 2003 Oct;24(10):731-43.<\/span><\/li>\n<li id=\"cite_note-:0-11\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:0_11-0\">11.0<\/a><\/sup> <sup><a href=\"#cite_ref-:0_11-1\">11.1<\/a><\/sup> <sup><a href=\"#cite_ref-:0_11-2\">11.2<\/a><\/sup> <sup><a href=\"#cite_ref-:0_11-3\">11.3<\/a><\/sup><\/span> <span class=\"reference-text\">Senga Y, Nishimura A, Ito N, Kitaura Y, Sudo A. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8439031\/pdf\/12891_2021_Article_4666.pdf\">Prevalence of and risk factors for hallux rigidus: a cross-sectional study in Japan<\/a>. BMC Musculoskelet Disord. 2021 Sep 13;22(1):786. <\/span><\/li>\n<li id=\"cite_note-:6-12\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:6_12-0\">12.0<\/a><\/sup> <sup><a href=\"#cite_ref-:6_12-1\">12.1<\/a><\/sup><\/span> <span class=\"reference-text\">Rubio-Lorenzo M, Prieto-Monta\u00f1a JR. Epidemiological factors of hallux rigidus. Orthopaedic Proceedings 2018; 91-B, No. SUPP_II. Available from <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/online.boneandjoint.org.uk\/doi\/abs\/10.1302\/0301-620X.91BSUPP_II.0910324c\">https:\/\/online.boneandjoint.org.uk\/doi\/abs\/10.1302\/0301-620X.91BSUPP_II.0910324c<\/a> (last access 04.02.2023)<\/span><\/li>\n<li id=\"cite_note-13\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-13\">\u2191<\/a><\/span> <span class=\"reference-text\">Beeson P, Phillips C, Corr S, Ribbans WJ. Hallux rigidus: a cross-sectional study to evaluate clinical parameters. Foot (Edinb). 2009 Jun;19(2):80-92.<\/span><\/li>\n<li id=\"cite_note-:3-14\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:3_14-0\">14.0<\/a><\/sup> <sup><a href=\"#cite_ref-:3_14-1\">14.1<\/a><\/sup> <sup><a href=\"#cite_ref-:3_14-2\">14.2<\/a><\/sup> <sup><a href=\"#cite_ref-:3_14-3\">14.3<\/a><\/sup><\/span> <span class=\"reference-text\">Allan JJ, McClelland JA, Munteanu SE, Buldt AK, Landorf KB, Roddy E, Auhl M, Menz HB. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7278053\/pdf\/13047_2020_Article_404.pdf\">First metatarsophalangeal joint range of motion is associated with lower limb kinematics in individuals with first metatarsophalangeal joint osteoarthritis.<\/a> J Foot Ankle Res. 2020 Jun 8;13(1):33. <\/span><\/li>\n<li id=\"cite_note-15\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-15\">\u2191<\/a><\/span> <span class=\"reference-text\">Miana A, Paola M, Duarte M, Nery C, Freitas M. Gait and Balance Biomechanical Characteristics of Patients With Grades III and IV Hallux Rigidus. J Foot Ankle Surg. 2022 May-Jun;61(3):452-455.<\/span><\/li>\n<li id=\"cite_note-16\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-16\">\u2191<\/a><\/span> <span class=\"reference-text\">Stevens J, de Bot RTAL, Hermus JPS, Schotanus MGM, Meijer K, Witlox AM. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/reader.elsevier.com\/reader\/sd\/pii\/S1268773122001060?token=D150D2243707D61D357316F2BC31D8C1D04EE2C48A8E8BA29C6F995ED838D10ACB4B1D4425437B7B137D6EDD8F7E6356&amp;originRegion=eu-west-1&amp;originCreation=20230204115057\">Gait analysis of foot compensation in symptomatic Hallux Rigidus patients.<\/a> Foot Ankle Surg. 2022 Dec;28(8):1272-1278.<\/span> <\/li>\n<li id=\"cite_note-17\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-17\">\u2191<\/a><\/span> <span class=\"reference-text\">Arrondo G, Casola L. Hallux rigidus clinical examination, radiology, and classification. J Foot Ankle. 2021;15(3):198-200.<\/span><\/li>\n<li id=\"cite_note-:4-18\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:4_18-0\">18.0<\/a><\/sup> <sup><a href=\"#cite_ref-:4_18-1\">18.1<\/a><\/sup> <sup><a href=\"#cite_ref-:4_18-2\">18.2<\/a><\/sup><\/span> <span class=\"reference-text\">Dillard S, Schilero C, Chiang S, Pham P. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6677635\/pdf\/nihms-1042977.pdf\">Intra- and Interobserver Reliability of Three Classification Systems for Hallux Rigidus.<\/a> J Am Podiatr Med Assoc. 2018 Apr 18:10.7547\/16-126.<\/span><\/li>\n<li id=\"cite_note-Hattrup_and_Johnson-19\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-Hattrup_and_Johnson_19-0\">19.0<\/a><\/sup> <sup><a href=\"#cite_ref-Hattrup_and_Johnson_19-1\">19.1<\/a><\/sup><\/span> <span class=\"reference-text\">Hattrup SJ, Johnson KA. Subjective results of hallux rigidus following treatment with cheilectomy. Clin Orthop 1988;226:182-91<\/span><\/li>\n<li id=\"cite_note-20\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-20\">\u2191<\/a><\/span> <span class=\"reference-text\">Coughlin MJ et al. Hallux rigidus. JBJS 2003; 85A:2072-88<\/span><\/li>\n<li id=\"cite_note-21\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-21\">\u2191<\/a><\/span> <span class=\"reference-text\">Bryant Ho B, Baumhauer J. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/eor.bioscientifica.com\/view\/journals\/eor\/2\/1\/2058-5241.2.160031.xml?body=pdf-50518\">Hallux rigidus<\/a>. EFORT Open Reviews 2017; 2(1): 13-20<\/span><\/li>\n<li id=\"cite_note-:8-22\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:8_22-0\">22.0<\/a><\/sup> <sup><a href=\"#cite_ref-:8_22-1\">22.1<\/a><\/sup><\/span> <span class=\"reference-text\">Lam A, Chan JJ, Surace MF, Vulcano E. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5434342\/pdf\/WJO-8-364.pdf\">Hallux rigidus: How do I approach it?<\/a> World J Orthop. 2017 May 18;8(5):364-371. <\/span><\/li>\n<li id=\"cite_note-23\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-23\">\u2191<\/a><\/span> <span class=\"reference-text\">Grice J, Marsland D, Smith G, Calder J. Efficacy of Foot and Ankle Corticosteroid Injections. Foot Ankle Int. 2017 Jan;38(1):8-13. <\/span><\/li>\n<li id=\"cite_note-24\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-24\">\u2191<\/a><\/span> <span class=\"reference-text\">Pons M, Alvarez F, Solana J, Viladot R, Varela L. Sodium hyaluronate in treating hallux rigidus. A single-blind, randomized study. Foot Ankle Int. 2007 Jan;28(1):38-42. <\/span><\/li>\n<li id=\"cite_note-:10-25\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:10_25-0\">25.0<\/a><\/sup> <sup><a href=\"#cite_ref-:10_25-1\">25.1<\/a><\/sup><\/span> <span class=\"reference-text\">Herrera-P\u00e9rez M, Pais-Brito JL, Valderrabano V, Cort\u00e9s-Garc\u00eda P, D\u00e9niz-Rodr\u00edguez B, Ayala-Rodrigo A. Propuesta de algoritmo terap\u00e9utico para hallux rigidus (Treatment algorithm proposed for hallux rigidus). Acta Ortop Mex. 2014 Jul-Aug;28(4):253-7. Spanish.<\/span><\/li>\n<li id=\"cite_note-26\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-26\">\u2191<\/a><\/span> <span class=\"reference-text\">Ho B, Baumhauer J. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5444234\/pdf\/eor-2-13.pdf\">Hallux rigidus<\/a>. EFORT Open Rev. 2017 Mar 13;2(1):13-20.<\/span><\/li>\n<li id=\"cite_note-27\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-27\">\u2191<\/a><\/span> <span class=\"reference-text\">Gait Doctor NZ. 3 &#8211; Hallux Rigidus. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=5tR7VSjgUEs\">https:\/\/www.youtube.com\/watch?v=5tR7VSjgUEs<\/a> (last accessed 5\/2\/2023)<\/span><\/li>\n<li id=\"cite_note-28\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-28\">\u2191<\/a><\/span> <span class=\"reference-text\">Ortho Eval Pal with Paul Marquis PT. Big Toe Pain \u00ab\u00a0FIX\u00a0\u00bb with Carbon Plate. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"https:\/\/www.youtube.com\/watch?v=3mbI9qMEW6o\">https:\/\/www.youtube.com\/watch?v=3mbI9qMEW6o<\/a> (last accessed 5\/2\/2023)<\/span><\/li>\n<li id=\"cite_note-:9-29\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-:9_29-0\">29.0<\/a><\/sup> <sup><a href=\"#cite_ref-:9_29-1\">29.1<\/a><\/sup> <sup><a href=\"#cite_ref-:9_29-2\">29.2<\/a><\/sup><\/span> <span class=\"reference-text\">Shamus J, Shamus E, Gugel RN, Brucker BS, Skaruppa C. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.jospt.org\/doi\/epdf\/10.2519\/jospt.2004.34.7.368\">The effect of sesamoid mobilization, flexor hallucis strengthening, and gait training on reducing pain and restoring function in individuals with hallux limitus: a clinical trial.<\/a> J Orthop Sports Phys Ther. 2004 Jul;34(7):368-76.<\/span><\/li>\n<li id=\"cite_note-30\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-30\">\u2191<\/a><\/span> <span class=\"reference-text\">Kon Kam King C, Loh Sy J, Zheng Q, Mehta KV. <a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5318145\/pdf\/cureus-0009-00000000987.pdf\">Comprehensive Review of Non-Operative Management of Hallux Rigidus.<\/a> Cureus. 2017 Jan 20;9(1):e987. <\/span><\/li>\n<li id=\"cite_note-31\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-31\">\u2191<\/a><\/span> <span class=\"reference-text\">Joan Hope Craig. Functional hallux mobilization. Available from: <a rel=\"nofollow\" class=\"external free\" href=\"http:\/\/www.youtube.com\/watch?v=ZOur5I0RTVo\">http:\/\/www.youtube.com\/watch?v=ZOur5I0RTVo<\/a> (last accessed 5\/2\/2023)<\/span><\/li>\n<li id=\"cite_note-Mann_and_Clanton-32\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-Mann_and_Clanton_32-0\">32.0<\/a><\/sup> <sup><a href=\"#cite_ref-Mann_and_Clanton_32-1\">32.1<\/a><\/sup><\/span> <span class=\"reference-text\">Mann RA, Clanton TO. Hallux rigidus: treatment by cheilectomy. J Bone Jt Surg 1988; 70A:400-6<\/span><\/li>\n<li id=\"cite_note-33\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-33\">\u2191<\/a><\/span> <span class=\"reference-text\">Gould N. Foot and Ankle.1981 May; 1(6):315-20.<\/span><\/li>\n<li id=\"cite_note-Coughlin-34\"><span class=\"mw-cite-backlink\">\u2191 <sup><a href=\"#cite_ref-Coughlin_34-0\">34.0<\/a><\/sup> <sup><a href=\"#cite_ref-Coughlin_34-1\">34.1<\/a><\/sup><\/span> <span class=\"reference-text\">Coughlin MJ, Shurnas PS. Hallux rigidus. Grading and long-term results of operative treatment. J Bone Joint Surg Am. 2003 Nov;85(11):2072-88. <\/span> <\/li>\n<li id=\"cite_note-35\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-35\">\u2191<\/a><\/span> <span class=\"reference-text\">Keller&rsquo;s arthroplasty. J Bone Jt Surg 1990; 72B:839-42<\/span><\/li>\n<li id=\"cite_note-36\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-36\">\u2191<\/a><\/span> <span class=\"reference-text\">Blewett N, Greiss ME. Long-term outcomes following Keller\u2019s excision arthroplasty of the great toe. Foot 1993; 3:144-7<\/span><\/li>\n<li id=\"cite_note-37\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-37\">\u2191<\/a><\/span> <span class=\"reference-text\">Brodsky JW, Baum BS, Pollo FE, Mehta H. Prospective gait analysis in patients with first metatarsophalangeal joint arthrodesis for hallux rigidus. Foot Ankle International. 2007 Feb;28(2):162-5<\/span><\/li>\n<li id=\"cite_note-38\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-38\">\u2191<\/a><\/span> <span class=\"reference-text\">O&rsquo;Doherty DP, Lowrie IG, Magnussen PA, Gregg PJ. The management of the painful first metatarsophalangeal joint in the older patient. Arthrodesis or Keller&rsquo;s arthroplasty? J Bone Joint Surg Br. 1990 Sep;72(5):839-42. <\/span><\/li>\n<li id=\"cite_note-39\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-39\">\u2191<\/a><\/span> <span class=\"reference-text\">Coughlin MJ, Shurnas PJ. Soft-tissue arthroplasty for hallux rigidus. Foot Ankle International. 2003 Sep;24(9):661-72.<\/span><\/li>\n<\/ol>\n<\/div>\n<p><!-- NewPP limit report Cached time: 20230404111252 Cache expiry: 0 Dynamic content: true Complications: () CPU time usage: 0.225 seconds Real time usage: 0.248 seconds Preprocessor visited node count: 743\/1000000 Post\u2010expand include size: 147\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/40 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 26370\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 29.738 1 Special:Contributors\/Hallux_Rigidus 100.00% 29.738 1 -total --><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u00c9diteur original &#8211; Tracy Hall Principaux contributeurs &#8211; Admin, Ewa Jaraczewska, Rachel Lowe , Tracy Hall, Jess Bell, Laura Ritchie, Kim Jackson, Ilse De Bode, Simisola Ajeyalemi et Khloud Shreif Contenu 1 Introduction 2 Anatomie cliniquement pertinente 2.1 La structure 2.2 Amplitude de mouvement 3 Fonction de l&rsquo;hallux 4 \u00c9tiologie 4.1 Facteurs de risque 5 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-5652","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/5652","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/comments?post=5652"}],"version-history":[{"count":4,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/5652\/revisions"}],"predecessor-version":[{"id":5736,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/5652\/revisions\/5736"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=5652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}