Cracchiolo A
Department of Orthopaedic Surgery, University of California, Los Angeles 90024, USA.
Clin Orthop Relat Res. 1997 Jul(340):58-68. doi: 10.1097/00003086-199707000-00009.
Rheumatoid arthritis frequently involves the hindfoot. It may produce a proliferative synovial hypertrophy around the tendons and a gradual destruction of the joints. Unfortunately, this part of the foot frequently is overlooked when caring for these patients who often have multiple areas of involvement giving pain and producing a deformity. Treatment consists of nonoperative measures such as proper footwear, physical modalities, and occasional injections of corticosteroids. It is important to preserve the function of the posterior tibial tendon and not allow the hindfoot to develop a valgus deformity. Arthrodesis of selected hindfoot joints provides relief of pain and prevents or corrects hindfoot deformity. It is critical to evaluate simultaneously the ankle joint in all these patients.
类风湿关节炎常累及后足。它可能导致肌腱周围滑膜增生肥大以及关节的逐渐破坏。不幸的是，在照料这些常有多处疼痛和畸形的患者时，足部的这一部分常常被忽视。治疗包括非手术措施，如合适的鞋具、物理治疗方式以及偶尔注射皮质类固醇。保留胫后肌腱的功能并防止后足出现外翻畸形很重要。对选定的后足关节进行关节融合术可缓解疼痛并预防或纠正后足畸形。对所有这些患者同时评估踝关节至关重要。
