Cheilectomy for hallux rigidus
introduction
A so-called hallux rigidus is caused by long-term wear and tear of the joints, i.e. osteoarthritis in the metatarsophalangeal joint. This leads to an increasing painful stiffening of the joint.
In some cases, hallux rigidus occurs in combination with hallux valgus (a foot misalignment where the toe points toward the outside of the foot), which can make symptoms worse.
The cheilectomy is an operative therapy method for the treatment of rather mild forms of the disease, in which, however, all conservative methods have already been exhausted.
Also read: Hallux rigidus
Symptoms
Due to the increasing rigidity of the Big toe joint the normal rolling movement of the Foot, which is essential in running, is handicapped. Because of this it comes to severe pain. Since the rolling movement can only be insufficiently compensated, it will be soon neither walking nor running possible without pain.
Hallux rigidus can also be recognized by one decreased dorsiflexion (Pull toes up), an inflammation of the joint with possible swelling and bony attachments to the already existing foot bones (Osteophytes).
Osteophytes appear particularly frequently on the heads of the Metatarsal bones on. Patients can no longer access the symptom-free Toes stand, climb stairs or run uphill. A X-ray image generally secures the diagnosis.
causes
Of the Hallux rigidus is a consequence of one arthrosis of Jointthat has developed over a long time. Partly is his appearance genetically conditional, however, some factors are also known that favor the development of this disease in particular.
Cartilage damage
Cartilage damage of all kinds, for example - as caused by accidents or Sports injuries can arise - as well Metabolic disorders, Incorrect loads of the foot through Joint misalignments, but also general overload of the joints speed up the process of arthrosis considerable.
indication
A cheilectomy should always be performed if all conservative treatment options were exhausted and themselves no significant improvement the symptoms have ceased.
On the other hand, the joint should not wear out yet to far advanced so be legitimate hope of one joint-preserving procedure consists.
The Big toe joint should still be flexible and sufficient cartilage exhibit; when losing over 50% of the cartilage mass it is already for a cheilectomy too late. It is then no longer the method of choice and should go through one more radical operational procedure be replaced.
The cheilectomy procedure for hallux rigidus
The cheilectomy is a common surgical method for treating hallux rigidus. The procedure is usually performed under general anesthesia. If there are contraindications or if there is a high risk of anesthesia, the procedure can alternatively be carried out under local anesthesia. The aim of the operation is to restore the mobility of the big toe as well as possible. For this purpose, new bone formation, so-called Osteophytesthat are part of the arthrosis are removed by the surgeon. In addition, the back of the bony head on the big toe is often removed so that the patient can straighten the big toe more easily. Overall, the cheilectomy is not a major procedure with many risks. The operation only takes a few hours and the foot can be carefully loaded again after the operation. After the operation, regular wound checks with a dressing change and anti-inflammatory medication are recommended. After two weeks at the latest, the wound healing is so advanced in most patients that the bandage can be removed.
You may also be interested in this article: Pain Management After Surgery
diagnosis
As already mentioned, a is used to confirm the diagnosis of hallux rigidus X-ray image of Foot. On this are for the experienced doctor one narrowed joint space and small extensions (Osteophytes) to recognize.
In most cases, however, these are typical Hallux rigidus symptoms already pointing the way: one recognizes one thickening of Joint With Redness and a light to moderate overheat.
Last but not least is the Restriction of movementthat the patients experience to mention. This is often the reason for visiting the doctor.
forecast
In the natural course - so without therapeutic intervention - the hallux rigidus shows one progressive course, so it gets worse over time. After a cheilectomy is a delayed progression the disease to be expected. Unfortunately, it cannot be ended entirely.
After the operation, the patient is allowed to use the foot again immediately Special shoe with a rigid sole burden. This slowly increases the mobility of the operated area. From the second Day after the operation passive movements in the jointwhich the patient also learns and should then practice independently, necessary and conducive to healing.
After about 2-3 weeks finally the change to one occurs softer shoe.
Just in Initial stage des Hallux rigidus shows the cheilectomy excellent results and can delay further cartilage injuries for a relatively long time.
prophylaxis
To one Hallux rigidus to prevent, one should avoid the things that can be influenced. One of the beneficial factors is wearing suitable footwear (not too small!) and the sensible use of physical activity. Joggers in particular should take care not to run too long distances, and theirs Observe regeneration times.
With a well-known Misalignment in the Big toe joint can also deal with the unfavorable load with orthopedic insoles at least partially counteracted.
