["Hallux rigidus"--a global problem?].
The diagnosis "hallux rigidus" is used for limitation of great toe motion, which is particularly painful at push-off during gait. The underlying condition is often degenerative arthrosis of the first metatarsophalangeal joint. Radiographs show no abnormality initially, later degeneration sets in at the dorsal aspect of the joint. Conservative treatment mainly consists of local anti-inflammatory applications and orthopaedic appliances to decrease load at the metatarsophalangeal joint. With progression of the arthrosis, joint preserving procedures such as cheilectomy are used. With this technique, the degenerated dorsal part of the first metatarsal head is resected. In complete destruction of the joint space, arthrodesis is the technique of choice in the mostly active, younger patients. Resection arthroplasty is a simple technique which is used in elderly, less active patients. The results of first metatarsophalangeal joint replacement are inferior to arthrodesis.
Wülker
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Orthopädische Universitätsklinik, Tübingen. wuelker@med.uni-tuebingen.de
D000328:Adult; D000367:Age Factors; D000368:Aged; D001174:Arthrodesis; D005530:Foot Deformities / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy; D005684:Gait; D006801:Humans; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D011859:Radiography; D014034:Toes / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery