|
|
Osteoarthritis and Arthritic Types
Hallux Valgus with Osteoarthritis
Before planning any treatment, it is very important to find
out if the patient shows any signs of osteoarthritis in the first metatarsophalangeal
joint, since this joint has to be decompressed (made less tight). The surgeon also undertakes to reduce
premature articular contacts.
Hallux Valgus with Arthritis
Several rheumatological diseases can generate a Hallux Valgus conditions. Among others are Rheumatoid Arthritis and Psoriatic Arthritis.
The inflammatory damage causes articular synovitis in the joints. In due course, those joints are destroyed. However, this happens in different degrees and rates among patients, depending on how controlled the rheumatoid disease can be... Before the deterioration of the cartilage, the articular capsules and the ligaments next to the joint are more affected. The ligaments stretch more and more and eventually cannot maintain the joints in place. In most cases, the disease affects not only the big toe, but the other metatarsophalangeal joints are involved as well. This causes not only a Hallux Valgus, but also a sagging of the other metatarsals with dorsal luxation of the phalanx. In turn, this makes a plantar bony protusions and causes secondary callus (which correspond with the metatarsal heads just under the skin, as the “fat pad” has moved further to the front of the foot).
 |
| So one must consider the stage of the rheumatoid disease, how controlled the disease is, and other associated deformities. When the cartilage of the first metatarsal head is not too damaged, the surgeon can attempt to save the joint of the big toe. In the severe example case shown herewith, one has to proceed another way (cf. section on treatments). |
|
