Anderson Michael R, Ho Bryant S, Baumhauer Judith F
Summit Orthopedics, Woodbury, MN, USA.
Hinsdale Orthopedics, Hinsdale, IL, USA.
Foot Ankle Orthop. 2023 Jul 25;8(3):24730114231188123. doi: 10.1177/24730114231188123. eCollection 2023 Jul.
Arthritis of the first metatarsophalangeal (MTP) joint, hallux rigid, is a common and disabling source of foot pain in the adult population. Hallux rigidus is characterized by diseased cartilage and large, periarticular osteophytes that result in a stiff, painful joint. Activity modification, sensible shoes, orthotics, anti-inflammatory medications and occasional intra-articular steroid injections can be attempted to alleviate the discomfort associated with hallux rigidus. A number of surgical options exist for the treatment of recalcitrant hallux rigidus. Cheilectomy is a useful treatment for dorsal impingement pain seen in mild hallux rigidus. A new polyvinyl alcohol hemi-arthroplasty implant has shown promising early and midterm results in the treatment of advanced hallux rigidus; however, arthrodesis of the first MTP joint remains the gold standard treatment for advanced hallux rigidus because of unpredictable outcomes after early-generation joint replacement implants.
第一跖趾（MTP）关节的关节炎，即僵硬拇趾，是成年人群中常见且致残的足部疼痛来源。僵硬拇趾的特征是软骨病变和关节周围大的骨赘，导致关节僵硬、疼痛。可以尝试改变活动方式、穿合适的鞋子、使用矫形器、服用抗炎药物以及偶尔进行关节内类固醇注射来减轻与僵硬拇趾相关的不适。治疗顽固性僵硬拇趾有多种手术选择。对于轻度僵硬拇趾中出现的背侧撞击痛，切除术是一种有效的治疗方法。一种新型聚乙烯醇半关节置换植入物在治疗晚期僵硬拇趾方面已显示出有前景的早期和中期结果；然而，由于早期关节置换植入物后结果不可预测，第一跖趾关节融合术仍然是晚期僵硬拇趾的金标准治疗方法。
