Tedeschi Roberto
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
Int J Surg Case Rep. 2024 Jan;114:109197. doi: 10.1016/j.ijscr.2023.109197. Epub 2023 Dec 24.
Hallux rigidus (HR) is a degenerative arthritis affecting the first metatarsophalangeal joint (MTP), leading to pain and functional impairment, particularly during the propulsive phase of walking. The prevalence of HR is about 2.5 % in individuals over 50, but younger individuals can also be affected, as demonstrated in this case.
We report the case of a 26-year-old patient with a body mass index (BMI) of 20.2, who has been suffering from HR for 5 years. The patient presented with walking difficulties, characterized by a limp and impaired propulsion phase, and pain in the right foot due to HR. A comprehensive gait assessment was conducted using a baropodometric platform and integrated smartphone motion sensors. Following the diagnosis, a non-surgical intervention involving the application of a compressed cotton felt foot orthosis at the MTP plantar area was initiated. This intervention aimed to alleviate pain and improve the functional mobility of the right big toe. Post-treatment assessments showed an increase in the big toe's mobility from 0 degrees to 35 degrees, as measured by a digital goniometer.
The application of a soft support, such as compressed cotton felt, at the plantar area of MTP, demonstrated a potential non-surgical therapeutic approach to improve gait and reduce discomfort in HR patients.
This case study underscores the potential benefits of plantar modification in the management of HR.
僵硬性拇趾（HR）是一种影响第一跖趾关节（MTP）的退行性关节炎，会导致疼痛和功能障碍，尤其是在步行的推进阶段。HR在50岁以上人群中的患病率约为2.5%，但如本病例所示，年轻个体也可能受到影响。
我们报告了一例26岁、体重指数（BMI）为20.2的患者，其患HR已5年。该患者表现出行走困难，特征为跛行和推进阶段受损，以及因HR导致的右脚疼痛。使用压力式足底测力平台和集成的智能手机运动传感器进行了全面的步态评估。诊断后，开始了一项非手术干预，即在MTP足底区域应用压缩棉毡足部矫形器。该干预旨在减轻疼痛并改善右拇趾的功能活动度。治疗后评估显示，通过数字角度计测量，拇趾的活动度从0度增加到了35度。
在MTP足底区域应用柔软支撑物，如压缩棉毡，证明了一种潜在的非手术治疗方法，可改善HR患者的步态并减轻不适。
本病例研究强调了足底改良在HR治疗中的潜在益处。
