Truckenbrodt H, Häfner R, von Altenbockum C
Children's Hospital, Department of Pediatric Rheumatology, Garmisch-Partenkirchen, Germany.
Clin Exp Rheumatol. 1994 Sep-Oct;12 Suppl 10:S91-6.
In juvenile chronic arthritis, foot joints become affected relatively frequently. Depending on the pattern of joint involvement, different deviations or deformities can develop. The most important malpositions are pes valgoplanus, pes cavus, heelfoot (pseudocavus), hallux flexus resp. rigidus, hallux valgus, forefoot adduction and claw or hammer toes. Combinations of several deviations occur frequently. Foot involvement influences the gait pattern. Usually the heel strike phase is shortened. The loading and push-off phases are disturbed according to the pattern of joint involvement and the resulting malpositions. A muscular imbalance develops which is mainly characterized by a hypertense tibialis anterior muscle and atrophy of the triceps sursae. Successful treatment requires adequate drug therapy as well as functionally oriented individual physiotherapy supported by foot adapted insoles and partial relief from weight-bearing.
在青少年慢性关节炎中，足部关节相对频繁地受到影响。根据关节受累模式，会出现不同的偏差或畸形。最重要的位置异常是扁平外翻足、高弓足、足跟畸形（假高弓足）、屈曲或僵硬拇趾、拇外翻、前足内收以及爪形趾或槌状趾。几种偏差常常合并出现。足部受累会影响步态模式。通常足跟触地阶段会缩短。负重和蹬离阶段会根据关节受累模式及由此产生的位置异常而受到干扰。会出现肌肉失衡，主要表现为胫骨前肌紧张和小腿三头肌萎缩。成功的治疗需要适当的药物治疗以及以功能为导向的个体化物理治疗，并辅以适合足部的鞋垫以及部分减轻负重。
