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僵硬性拇趾的临床表现与治疗

Clinical Presentation and Management of Hallux Rigidus.

作者信息

Hamid Kamran S, Parekh Selene G

机构信息

Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.

Department of Orthopaedic Surgery, North Carolina Orthopaedic Clinic, Duke University School of Medicine, 3609 Southwest Durham Drive, Durham, NC 27707, USA.

出版信息

Foot Ankle Clin. 2015 Sep;20(3):391-9. doi: 10.1016/j.fcl.2015.04.002. Epub 2015 Jul 2.

Abstract

Hallux rigidus is the most commonly occurring arthritic condition of the foot and is marked by pain, limited motion in the sagittal plane of the first metatarsophalangeal joint and varying degrees of functional impairment. In conjunction with clinical findings, radiographic grading helps guide therapeutic choices. Nonsurgical management with anti-inflammatory medications, corticosteroid injections, or shoewear and activity modifications can be successful in appropriately selected patients. Patients with more severe disease or refractory to conservative management may benefit from surgical intervention. Operative options range from joint-preserving procedures (eg, cheilectomy with or without associated osteotomies) to joint-altering procedures (eg, arthroplasty or arthrodesis).

摘要

僵硬性拇趾是足部最常见的关节炎病症,其特征为疼痛、第一跖趾关节矢状面活动受限以及不同程度的功能障碍。结合临床检查结果,影像学分级有助于指导治疗方案的选择。对于经过适当挑选的患者,使用抗炎药物、皮质类固醇注射或调整鞋具及活动等非手术治疗方法可能会取得成功。病情较重或对保守治疗无效的患者可能会从手术干预中获益。手术选择范围从保留关节的手术(如伴或不伴相关截骨术的关节切除术)到改变关节的手术(如关节成形术或关节融合术)。

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