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Arthrosis of First Metatarsophalangeal Joint

Arthrosis of the first metatarsophalangeal joint (scientifically called Hallux rigidus) is degenerative arthritis ranging from moderate to severe. Young people often develop the pathology due to an injury. Actual causes are still unknown: it can be a metabolic disorder, injury, rheumatoid arthritis, inflammatory diseases.

Pathophysiology 

The pathologic condition causes various tendon injuries, pathologic biomechanics in the joint, formation of osteophytes mainly on the back part of the head of the first metatarsal bone. Pain is caused by impingement of osteophytes and further inflammation. Tight footwear makes the condition worse. Such modifications can lead to roughness on the articular surfaces of the first metatarsophalangeal joint. As a result, the joint gets painful on movement. Arthrosis of the first metatarsophalangeal joint can develop in adolescents and young people as well as in adults.

Clinical implications 

The condition is characterized by pain upon walking, limitation of movement, stiffness, bigger size of the joint and inflammation

Diagnostics 

Diagnosis is made based on the medical history, roentgenography, palpation and clinical implications. 

Conservative treatment 

Patients are recommended to wear loose footwear with a low heel or special orthopedic footwear. It is important to limit movement in the first metatarsophalangeal joint. In order to relieve pain and local inflammation it is recommended to use non-steroidal anti-inflammatory drugs. Sometimes steroidal drugs are prescribed. 

Surgical treatment 

If conservative treatment turns ineffective and you have strong pain, a surgery can be performed after consideration of all complaints and examination results, X-ray scanning and palpation results. The surgery implies incision of exostoses and/or incision of metatarsal bones and their fixation if necessary; arthrodesis (immobilization of joint) with further endoprosthesis replacement.

 

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