If symptoms persist or recur despite conservative therapy, surgical therapy should be considered. Because osteoarthritis is a progressive (advancing) disease, joint-preserving surgery is usually associated with only temporary success. The following surgical therapies may be used, depending on the symptoms or degree of joint damage: Arthrodesis (stiffening) of the metacarpophalangeal joint. Indications: Severe form of … Hallux Rigidus: Surgical Therapy
To prevent hallux rigidus, attention must be paid to reducing individual risk factors. Behavioral risk factors Overweight (BMI ≥ 25; obesity) and thereby incorrect loading/overloading of the foot. Improper footwear such as high heels.
The anamnesis (medical history) represents an important component in the diagnosis of hallux rigidus. Family history Are there any hereditary diseases in your family? Are there frequent arthritic changes such as hallux rigidus in your family? Social history What is your profession? Do you often wear shoes with high heels? Current medical history/systemic history (somatic … Hallux Rigidus: Medical History
Hallux rigidus is clearly recognized on clinical examination (thus, there are no differential diagnoses for this clinical picture).
The following are the most important diseases or complications that can be caused by hallux rigidus: Musculoskeletal system and connective tissue (M00-M99). Movement restriction Malposition of the entire body and resulting discomfort at the knee and hip joint. Joint stiffness in the metatarsophalangeal joint of the big toe Symptoms and abnormal clinical and laboratory findings … Hallux Rigidus: Secondary Diseases
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin (Normal: intact; abrasions/wounds, redness, hematomas (bruises), scars). Gait (fluid, limping). Malpositions (deformities, contractures, shortenings). Joint (abrasions/wounds, swelling (tumor), redness (rubor), hyperthermia (calor); injury evidence such as hematoma formation, … Hallux Rigidus: Examination
2nd order laboratory parameters – depending on the results of the medical history, physical examination, etc. – for differential diagnostic clarification Uric acid in blood serum – for suspected gout/hyperuricemia. Further laboratory diagnosis – taking into account age and concomitant diseases – is required if surgical action is to be taken.
Therapy goals Reduction of pain Increase/maintain the ability to move Therapy recommendations Anti-inflammatory drugs/medications that inhibit inflammatory processes (nonsteroidal anti-inflammatory drugs, NSAIDs), e.g., acetylsalicylic acid (ASA), ibuprofen, diclofenacNote: No diclofenac in cardiovascular risk! Affected are patients with heart failure (cardiac insufficiency) of NYHA classes II to IV, coronary artery disease (CAD, coronary artery disease), peripheral … Hallux Rigidus: Drug Therapy
Obligatory medical device diagnostics. X-ray examination of the foot – it show in hallux rigidus: Subchondral sclerosis (hardening of tissue below the cartilage) in the region of the proximal phalanx and the head of the first metatarsal bone Osteophyte marginal attachments (bone neoplasms). Narrowing of the joint space
The following symptoms and complaints may indicate hallux rigidus: Restriction of the mobility of the big toe Joint stiffness of the big toe Painful treading with the ball of the foot Pain in the metatarsophalangeal joint of the big toe, especially when rolling, as the extensor ability of the big toe, which is important for … Hallux Rigidus: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The factors that promote osteoarthritis (wear and tear of the articular cartilage) in the metatarsophalangeal joint of the big toe are very diverse. Usually, injuries cause damage to the articular cartilage and promote the development of osteoarthritis. Often the cause is congenital poor cartilage. Misuse and overloading also come into question. … Hallux Rigidus: Causes
If hallux rigidus is based on a disease such as hyperuricemia/gout, its therapy is the main focus. General measures Shoes should be adapted to the individual foot shape and have a hard sole. Avoid shoes with high heels Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by … Hallux Rigidus: Therapy
