Waizy Hazibullah, Panahi Babak, Dohle Jörn, Stukenborg-Colsman Christina
Hessing Stiftung, Augsburg.
Labor für Biomechanik und Biomaterialien, Medizinische Hochschule Hannover.
Z Orthop Unfall. 2019 Feb;157(1):75-82. doi: 10.1055/a-0623-2966. Epub 2018 Jul 3.
The hallux valgus deformity is untreated usually regarded as progressive deformity that does not necessarily lead to pain and suffering for the patient. Prevention primary: foot conforming footwear to avoid bruising and to avoid a forced progression of pathology. Functional stabilization of the foot by means of gymnastics or physiotherapy instructions. Secondary: orthotic and/or insoles to improve the functional stabilization. Tertiary: consistent adapted postoperative treatment, which is based on the operation procedure. The indication for initiation of a therapeutic measure is based on the suffering of the patient, age and presence of arthritis in the MTP-I-joint. More patient-specific pathologies may affect the initiation of treatment also. In the first stage of outpatient consultation and physiotherapy are at the forefront, additive analgesic or anti-inflammatory medication. Manual therapies, physiotherapy, orthotics or orthopedic measures adopted in view of the existing pathology and suffering pressure. In stage 2 of outpatient or inpatient surgical treatment therapeutic measures are indicated when symptomatic hallux valgus surgical therapy should be oriented on the severity of the pathology and the postoperative mobilization possibilities of the patient and other patient-specific criteria.
拇外翻畸形若不治疗，通常被视为一种进行性畸形，不一定会给患者带来疼痛和痛苦。预防主要措施：选择合脚的鞋子，避免擦伤，防止病情被迫进展。通过体操或物理治疗指导实现足部功能稳定。次要措施：使用矫形器和/或鞋垫改善功能稳定。第三级措施：根据手术程序进行持续的适应性术后治疗。采取治疗措施的指征基于患者的痛苦、年龄以及第一跖趾关节是否存在关节炎。更多特定于患者的病理情况也可能影响治疗的启动。在第一阶段，门诊咨询和物理治疗是首要的，辅助使用止痛或抗炎药物。根据现有病理情况和受压痛苦采取手法治疗、物理治疗、矫形器或矫形措施。在第二阶段，若出现症状性拇外翻，则需进行门诊或住院手术治疗，手术治疗措施应根据病情严重程度、患者术后活动可能性及其他特定于患者的标准来确定。
