Master the clinical assessment and surgical management of hallux rigidus, the most common arthritic condition of the foot. We explore the Carp classification, grading systemsand the critical decision-making process between joint-preserving cheilectomy and first metatarsophalangeal joint arthrodesis. ⏱ Chapters 0:00 Intro 0:21 Essentials 1:02 Carp 1:48 Imaging 2:33 Dorsal 3:03 Vdn 3:29 Staging 4:05 Algorithm 4:48 Numbers 5:32 Clinical reasoning — Grading 6:09 Clinical reasoning — Fusion This in-depth Orthovellum masterclass provides a comprehensive breakdown of first metatarsophalangeal joint arthritis. Viewers will understand the biomechanical demands of the joint, learn how to interpret weight-bearing radiographs for grading severityand explore the management algorithm. The video covers the Carp and Hattrup-Johnson classification systems in detail, alongside the specific indications for cheilectomy versus arthrodesis, providing a complete framework for treating hallux rigidus. 🦴 IN THIS VIDEO YOU'LL LEARN • Understand the biomechanics of the first MTP joint and normal dorsiflexion requirements for gait • Identify the radiographic findings and clinical signs used to grade hallux rigidus • Differentiate between primary idiopathic and secondary causes of first MTP arthritis • Apply the Carp classification (Grades 0-4) to guide your orthopaedic surgical decision-making • Use the Hattrup-Johnson system as a simpler alternative for research and clinical communication • Identify the specific indications for a joint-preserving cheilectomy using the DORSAL mnemonic • Determine the optimal fusion position for first MTP arthrodesis using the VDN rule • Recognise when to escalate from cheilectomy to arthrodesis based on plantar cartilage preservation ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Hallux rigidus grading directly dictates treatment: Carp Grades 1-2 are typically managed with cheilectomy, while Grades 3-4 require arthrodesis. ✔️ A cheilectomy is contraindicated if cartilage loss extends beyond the dorsal third of the joint; the plantar two-thirds must be preserved. ✔️ Ideal first MTP arthrodesis fusion position requires 10-15 degrees of valgus, 15-20 degrees of dorsiflexion relative to the groundand neutral rotation. ✔️ The grind test (compression and rotation of the hallux) is highly specific for reproducing pain from intra-articular arthritis. ✔️ First MTP arthrodesis provides definitive management for advanced disease with a 90-95% fusion rate and high patient satisfaction. 👩⚕️ WHO THIS IS FOR This masterclass is essential for orthopaedic trainees, medical studentsand clinicians seeking a comprehensive understanding of foot and ankle pathology. Curious patients suffering from big toe joint stiffness and pain will also find valuable insights into their condition. 📚 RELATED TOPICS: First Metatarsophalangeal Joint Arthrodesis Surgical Technique · Cheilectomy and Dorsal Impingement Syndrome · Hallux Valgus Correction and Intermetatarsal Angles · Sesamoiditis and Turf Toe Pathomechanics · Osteochondritis Dissecans of the Metatarsal Head · Inflammatory Arthropathy and Gout in the Foot 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #halluxrigidus #orthopaedics #footandankle #carpclassification #cheilectomy #arthrodesis #mtpjoint #orthopaedicsurgery #footsurgery #halluxlimitus #medicalstudent #orthoteaching