Cheilectomy. A, Patient with stage II (radiographically) hallux rigidus; note dorsal osteophyte over first metatarsal. B, Incision is placed at lateral border of extensor hallucis longus. C, Dorsal sensory nerve to hallux is protected. D, First metatarsophalangeal joint is exposed. E, Dorsal osteophytes are removed from metatarsal head and base of proximal phalanx. Dorsolateral osteophyte frequently is present and must be removed. F, Between 20 and 25% of metatarsal head is removed dorsally. G, Joint is distracted, any loose cartilage and bone are removed, and joint is moved through 60 to 70 degrees of motion. Palpation through skin is done to ensure that no abnormal bony prominences remain. Capsule is closed with two or three absorbable sutures, and skin is closed with nylon sutures. SEE TECHNIQUE 82.32.