Hallux rigidus

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Classification according to ICD-10
M20.2 Hallux rigidus
ICD-10 online (WHO version 2019)

Hallux rigidus is the special term for the joint wear ( arthrosis ) of the big toe joint between the first metatarsal bone and the base of the big toe, which can lead to increasing and painful stiffening of the joint. Hallux rigidus can, but does not have to be, combined with hallux valgus , a misalignment of the big toe on the outside of the foot.

Meaning and remedy

The stiffening hinders the normal rolling load on the foot . One way of helping provide here Schuhzurichtungen constitute The shoe sole in the forefoot area in the manner of a will. Blotter (blotter) converted (following terms: front roller, ball or roller Vorfußrolle). The rolling movement then only runs over the shoe and no longer over the big toe . Similarly, the big toe can also be relieved in hiking boots that have a firm and thick sole with a ball roll.

The diagnosis can be made through the clinical examination . The limited mobility is typical mainly in dorsiflexion , often dorsal and medial bony noses ( osteophytes ) can be felt on the head of the first metatarsal bone .

Occasionally there are also signs of inflammation in the form of redness, swelling, and warming. In the X-ray image (left picture) there is a narrowing of the joint space - up to and including the abolition. The cause is abrasion of the cartilage . There are also protrusions on the joint surfaces.

There are also some surgical procedures in place to allow normal walking again. In the case of lighter forms, this includes the removal of the osteophytes, the cheilectomy . For more severe forms, this can be combined with a corrective osteotomy . The use of endoprostheses has so far not been able to establish itself due to a lack of success. In severe osteoarthritis, the stiffening ( arthrodesis ) of the metatarsophalangeal joint of the big toe is the most frequently used method, whereby the loss of movement is compensated by the neighboring joints and a ball roll, but the fusion of the two bones also leads to freedom from pain.

  • X-ray image (normal conditions in the box)

  • Clinical picture

  • OP findings

literature

  • Rüdiger Döhler : Lexicon Orthopedic Surgery . Springer, Heidelberg Berlin 2003, ISBN 3-540-41317-0 , p. 63 f.
  • A. Imhoff, R. Baumgartner, R. Linke: Orthopedic checklist . 2nd Edition. Thieme Verlag, Stuttgart et al. 2005, ISBN 3-13-142281-5 .
  • Angela Simon: Toe deformities , in: Margret Liehn, Brigitte Lengersdorf, Lutz Steinmüller, Rüdiger Döhler: OP manual. Basics, instruments, operating procedures , 6th, updated and expanded edition. Springer, Berlin Heidelberg New York 2016, ISBN 978-3-662-49280-2 , pp. 250-252.

Web links