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Operative Therapie – 1. Strahl

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Book cover Vorfußchirurgie

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Zusammenfassung

Der Hallux rigidus ist eine zunehmende Einsteifung im Großzehengrundgelenk, beginnend mit der schmerzhaften Einschränkung der Dorsalextension. In die Entscheidung, welche Operation gewählt wird, sollte immer die Beurteilung des Röntgenbildes mit eingebunden werden. Hier hat sich die Einteilung von Hattrop u. Johnson (1988) in 3 Gruppen bewährt:

Grad 1 zeigt radiologisch nur geringe arthrotische Veränderungen. Der Patient stellt sich hauptsächlich wegen einer eingeschränkten Dorsalextension der Großzehen vor. Die Sesambeine sind regulär, aber im Verhältnis zu normalen Sesambeinen minimal vergrößert.

Grad 2 ist gekennzeichnet durch eine Verschmälerung des Gelenkspaltes und Hypertrophie des subartikulären Knochens mit Sklerosierung. Der Patient kommt mit schmerzhafter Dorsalextension.

Grad 3 betrifft ein radiologisches Endstadium mit fast aufgehobenem Gelenkspalt und Randosteophyten, die zu einer Ummauerung führen. Der Patient hat fast keine Beweglichkeit mehr im Großzehengrundgelenk, klagt aber über Schmerzen.

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Authors and Affiliations

  1. DRK Klinik Baden-Baden, Lilienmattstr. 5, 76530, Baden-Baden, Deutschland

    Marc Thomsen Prof. Dr. med.

  2. Aukamm-Klinik GmbH, Leibnizstraße 21, 65191, Wiesbaden, Deutschland

    Markus Preis Dr. med.

  3. Orthopädische Gemeinschaftspraxis, Klinik St. Elisabeth, Max-Reger-Straße 5 - 7, 69121, Heidelberg, Deutschland

    Desiderius Sabo Prof. Dr. med. habil.

  4. Hessingparc-Clinic Augsburg, Hessingstr. 17, 86199, Augsburg, Deutschland

    Manfred Thomas Dr. med.

  5. Praxisklinik Ulm-Söflingen, Magirusstr. 35/4, 89077, Ulm, Deutschland

    Gebhard Suger Dr. med.

  6. Lange Lemppen 30, 89075, Ulm, Deutschland

    Christina Erdle

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  1. Marc Thomsen Prof. Dr. med.
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  1. Orthopädische Gemeinschaftspraxis, Klinik St. Elisabeth, Heidelberg, Deutschland

    Desiderius Sabo Prof. Dr. med. habil.

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Thomsen, M., Preis, M., Sabo, D., Thomas, M., Suger, G., Erdle, C. (2012). Operative Therapie – 1. Strahl. In: Sabo, D. (eds) Vorfußchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25876-3_7

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