概念
Characterized by first metatarsophalangeal joint (MTP) degeneration and joint pain.
臨床表現
Joint degeneration, formation of dorsal osteophytes, pain, limited range of motion.
查體
The pain should be classified as dorsal, medial, and/or sesamoidal.
Passive and active range of motion is decreased most notably in dorsiflexion.
Sensation deficits should be recorded preoperatively (dorsomedial cutaneous nerve)
影像學表現
Decreased joint space 關節間隙變窄
Joint sclerosis 關節硬化
Subchondral cysts 軟骨下骨囊腫
Exostoses 外生骨疣
a loose body 關節內游離體
分型
Coughlin and Shurnas developed a useful clinical and radiographical classification, which helps guide treatment of patients suffering from hallux rigidus.
治療
Non-surgical treatment includes:
Foot orthoses (足矯正器) with a firm support under the great toe (Morton’s extension), shoe wear modification, activity modification, medical therapy, and injection therapy.
For those patients who have failed nonoperative methods, there are many surgical options available.surgical treatment
Treatment for hallux rigidus has been classified as joint sparing versus joint sacrificing.
Joint sparing techniques include: cheilectomy, proximal phalangeal osteotomy, first metatarsal osteotomy and interpositional arthroplasty.
Joint sacrificing techniques include implant arthroplasty and arthrodesis.
