What modification should be added to the foot insert for hallux rigidus?

In the case of hallux rigidus, a condition characterized by stiffness and pain in the big toe joint, the aim of foot insert modifications is to alleviate pressure and improve function. Morton's extension is a specific modification that extends the insert under the first toe (the hallux) and is intended to limit motion at the first metatarsophalangeal joint. This extension can help to stabilize the first ray and provide relief from the discomfort associated with movement at the joint, making it easier for the patient to walk without pain.

The other modifications do not effectively address the primary issue associated with hallux rigidus. For instance, a met pad is aimed at redistributing pressure across the metatarsal heads but does not specifically assist with the limitations of the big toe joint. A cut-out may relieve pressure in certain areas but does not provide the additional support and stabilization needed in cases of hallux rigidus. Similarly, a cuboid wedge is designed to correct pronation or supination issues in the foot but does not offer targeted support or relief for the symptoms associated with hallux rigidus. Therefore, Morton's extension is the most appropriate choice for this condition.