Waizy Hazibullah, Claaßen Leif
Orthoprofis - Rückenprofis, Luisenstr. 10/11, 30159, Hannover, Deutschland.
Orthopadie (Heidelb). 2025 Jun;54(6):491-502. doi: 10.1007/s00132-025-04634-7. Epub 2025 Mar 18.
Hallux valgus, also known as a bunion, is one of the most frequent deformities of the forefoot. The prevalence is 23% in people between the ages of 18 and 65 years and 36% in people over 65 years of age. Hallux valgus deformity normally begins between the ages of 30 and 60 years. Women are overall more frequently affected than men. Hallux valgus is characterized by the valgus deviation of the big toe and the varus deviation of the first metatarsal bone (MT-I), also known as metatarsus primus varus. This deformity can lead to a pressure point on the medial MT‑I head due to shoe conflict and can restrict mobility. Hallux valgus is typically identifiable by a physical examination. Imaging techniques are important to assess the severity of the deformity and to rule out possible differential diagnoses, such as hallux rigidus. Hallux rigidus is a degenerative change of the first metatarsophalangeal joint (MTP‑I joint) and the second most common cause of pain in the MTP‑I joint. A combination of hallux valgus and hallux rigidus is not uncommon. The treatment of hallux valgus initially focuses on nonsurgical approaches such as wider shoes, orthoses and nocturnal splints. If conservative treatment is not effective, surgical treatment provides a proven therapeutic benefit. In recent years minimally invasive techniques have also made progress in foot surgery. In addition to the reduced soft tissue trauma, the extra-articular approach in particular shows a significant advantage. This article provides a current overview of hallux valgus by addressing five widespread myths.
拇外翻,也称为拇囊炎,是前足最常见的畸形之一。18至65岁人群中的患病率为23%,65岁以上人群中的患病率为36%。拇外翻畸形通常始于30至60岁之间。总体而言,女性比男性更易受影响。拇外翻的特征是大脚趾外翻和第一跖骨(MT-I)内翻,也称为第一跖骨内翻。由于鞋子摩擦,这种畸形会导致第一跖骨头内侧出现压痛点,并可能限制活动能力。拇外翻通常可通过体格检查来识别。影像学技术对于评估畸形的严重程度以及排除可能的鉴别诊断(如僵硬性拇趾)很重要。僵硬性拇趾是第一跖趾关节(MTP-I关节)的退行性改变,也是MTP-I关节疼痛的第二大常见原因。拇外翻和僵硬性拇趾同时存在并不罕见。拇外翻的治疗最初侧重于非手术方法,如穿更宽的鞋子、使用矫形器和夜间夹板。如果保守治疗无效,手术治疗则具有已证实的治疗效果。近年来,微创技术在足部手术中也取得了进展。除了减少软组织创伤外,特别是关节外入路显示出显著优势。本文通过解决五个普遍存在的误区,对拇外翻进行了当前概述。