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[跖痛症:鉴别诊断与治疗]

[Metatarsalgia: Differential diagnosis and therapy].

作者信息

Toepfer Andreas, von Eisenhart-Rothe Rüdiger, Harrasser Norbert

机构信息

Klinik für Orthopädie und Sportorthopädie, Klinikum Rechts der Isar, Technischen Universität München, Ismaninger Straße 22, 81675, München, Deutschland.

出版信息

Wien Med Wochenschr. 2017 Sep;167(11-12):285-292. doi: 10.1007/s10354-016-0445-2. Epub 2016 Mar 2.

Abstract

Metatarsalgia refers to localized or generalized forefoot pain in the region of the metatarsal heads. Symptoms can be isolated or in combination with accompanying deformities occurring in the forefoot and/or hindfoot. Anamnesis and clinical investigation usually yield to the diagnosis, the underlying cause on the other hand is not always easy to identify. In the foreground of the treatment is the exhaustion of conservative forms of therapy to minimize the symptoms of local pressure increase and callus under the metatarsal heads. In addition, various surgical methods are available, such as corrective osteotomy of the metatarsale bone, soft tissue interventions and the correction of associated deformities. The indications for surgical intervention should be made with caution in order to avoid failures and complaints persisting after surgery. The most common problems are an inadequate indication for surgery, technical problems and insufficient postoperative treatment.

摘要

跖痛症是指跖骨头区域的局限性或全身性前足疼痛。症状可以是孤立的,也可与前足和/或后足出现的伴随畸形同时存在。通过病史采集和临床检查通常可做出诊断,然而,其根本原因并不总是易于确定。治疗的重点是用尽保守治疗方法,以减轻跖骨头下方局部压力增加和胼胝的症状。此外,还有各种手术方法可供选择,如跖骨矫正截骨术、软组织干预以及相关畸形的矫正。手术干预的指征应谨慎确定,以避免术后出现手术失败和持续存在的问题。最常见的问题是手术指征不充分、技术问题以及术后治疗不足。

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