Hallux Limitus Classification Quiz

Questions and Answers

What is the classification for hallux limitus?

Regnauld classification (correct)

Olof classification (correct)

Drago classification

Modified Regnauld/Oloff classification (correct)

What are the stages of the Modified Regnauld/Oloff classification?

Stage 2 - Joint adaptation (correct)

Stage 3 - Joint deterioration (correct)

Stage 1 - Functional hallux limitus (correct)

Stage 4 - Congenital deformity

What symptoms or radiographic changes do you see in Regnauld/Oloff classification?

Stage 1 - No degeneration, no pain on range of motion, limited dorsiflexion weight-bearing; Stage 2 - Metatarsal head flattening, dorsal exostosis, pain at end range of motion; Stage 3 - Asymmetric joint space narrowing, osteophytes, subchondral cysts, and subchondral sclerosis; Stage 4 - No real range of motion.

What is the classification for Freiberg's Disease?

Smilie classification Signup and view all the answers

What are the stages of the Smilie classification?

Stage 1 - Fracture on MRI; Stage 2 - Radiograph shows the dorsal collapse; Stage 3 - Dorsal met head collapse, plantar aspect intact; Stage 4 - Dorsal and plantar collapse; Stage 5 - Joint space narrowing, arthritic changes. Signup and view all the answers

What are the classifications for 5th metatarsal fractures?

Stewart, Torg, and Chapman Signup and view all the answers

What are the associated published articles with 5th met base fractures?

Lawrence (1993) - differentiate the difference between Jones fracture, diaphyseal stress fracture, and avulsion fracture; Shereff (1991) - Apophysis fuses at 9-12 years old. Signup and view all the answers

What is the Stewart Classification system?

The Stewart Classification system outlines fractures of the base of the 5th metatarsal as follows: Type I - Extra-articular fx at metaphyseal-diaphyseal junction (True Jones Fracture); Type II - Intra-articular avulsion fracture; Type III - Extra-articular avulsion fracture; Type IV - Intra-articular, comminuted; Type V - Extra-articular avulsion fractures of the epiphysis, typically occurring in children. Signup and view all the answers

Study Notes

Classification of Hallux Limitus

Regnauld classification aids in the differentiation of hallux limitus severity.
Variants include Drago, Olof, and Jacobs classifications.
Modified Regnauld/Oloff further categorizes stages of the condition.

Modified Regnauld/Oloff Classification

Stage 1: Functional hallux limitus.
Stage 2: Joint adaptation occurs.
Stage 3: Joint deterioration is noted.
Stage 4: Ankylosis or fusion of the joint.

Symptoms and Radiographic Changes in Regnauld/Oloff Classification

Stage 1: No degeneration and absence of pain; limited dorsiflexion during weight-bearing activities.
Stage 2: Flattening of the metatarsal head; presence of dorsal exostosis; pain at maximum range of motion.
Stage 3: Asymmetrical narrowing of joint space; development of osteophytes, subchondral cysts, and sclerosis.
Stage 4: Loss of range of motion equating to 1 cm; potential need for skin grafts.

Classification for Freiberg's Disease

Smilie classification is used to categorize Freiberg's Disease.

Stages of Smilie Classification

Stage 1: Fracture visible on MRI.
Stage 2: Radiographs show dorsal collapse.
Stage 3: Collapse of the dorsal metatarsal head with intact plantar aspect.
Stage 4: Collapse of both dorsal and plantar aspects.
Stage 5: Presence of joint space narrowing and arthritic changes.

5th Metatarsal Fracture Classifications

Classifications include Stewart, Torg, and Chapman systems.

Published Articles on 5th Metatarsal Base Fractures

Lawrence (1993): Differentiation between Jones fractures, diaphyseal stress fractures, and avulsion fractures.
Shereff (1991): Indicates the apophysis fuses between 9-12 years; notes poor blood supply to the 5th metatarsal base, with nourishment primarily from the nutrient artery.

Stewart Classification System for 5th Metatarsal Fractures

Type I: Extra-articular fracture at the metaphyseal-diaphyseal junction (True Jones Fracture).
Type II: Intra-articular avulsion fracture.
Type III: Extra-articular avulsion fracture.
Type IV: Intra-articular and comminuted fracture.
Type V: Extra-articular avulsion fractures of the epiphysis, specific to children (Salter-Harris Type I fracture).

Description

Test your knowledge on the various classifications of hallux limitus, including the Regnauld and Modified Regnauld/Oloff classifications. Understand the stages and associated symptoms to enhance your grasp of this important topic in podiatry.