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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatur
Literatur zu Kapitel 7.1
Apard T, Casin C, Moubarak E, Bizot P (2011) A novel pyrolytic carbon implant for hallux rigidus: a cadaveric study. J Foot Ankle Surg 17 (3):182–185
Brandes M (1929) Zur operativen Therapie des Hallux valgus. Zentralbl Chir 56:2434–2440
Chee YH, Clement N, Ahmed I, Thomson CE, Gibson JN (2011) Functional outcomes following ceramic total joint replacement for hallux rigidus. J Foot Ankle Surg 17 (1):8–12
Coughlin MJ (1990) Arthrodesis of the first metatarsophalangeal joint with mini fragment plate fixation. Orthopedics 13:1037–1044
Coughlin MJ, Shurnas PS (2003) Hallux rigidus. Grading and long-term results of operative treatment. J Bone Joint Surg Am 85-A(11):2072–2088
Flamme CH, Wülker N, Kuckerts K, Rühmann O (1998) Langzeitergebnisse nach Arthroplastik im Großzehengrundgelenk. Z Orthop Ihre Grenzgeb 136:250–254
Hanyu T, Yamazaki H, Ishikawa H et al. (2001) Flexible hinge toe implant arthroplasty for rheumatoid arthritis of the first metatarsophalangeal joint: long term results. J Orthop Sci 6 (2):141–147
Hattrup SJ, Johnson KA (1988) Subjective results of hallux rigidus following treatment with cheilectomy. Clin Orthop Relat Res 226:182–191
Kramer J (1990) Die Kramer-Osteotomie zur Behandlung des Hallux valgus und des Digitus quintus varus. Oper Orthop Traumatol 2:29–38
Mann RA, Clanton TO (1988) Hallux rigidus: treatment by cheilectomy. J Bone Joint Surg 70:400–406
Mann RA, Coughin MJ, DuVries HL. (1979) Hallux rigidus: a review of the literature and a method of treatment. Clin Orthop Relat Res 142:57–63
Roukis TS (2010) The need for surgical revision after isolated cheilectomy for hallux rigidus: a systematic review. J Foot Ankle Surg 49 (5):465–470
Saxena A (1995) The Valenti procedure for halllux limitus/rigidus. J Foot Ankle Surg 34:485–488
Thomsen M. (1988) Therapie des Hallux valgus. Operative Erfahrungen der letzten 15 Jahre und die Spätergebnisse. Inauguraldissertation, Universität Heidelberg
Literatur zu Kapitel 7.2
Flamme CH, Wülker N, Kuckerts K, Rühmann O (1998) Long-term outcome of arthroplasty of the first metatarsophalangeal joint. Z Orthop Ihre Grenzgeb. 136(3):250–4
Grimes JS, Coughlin MJ (2006) First metatarsophalangeal joint arthrodesis as a treatment for failed hallux valgus surgery. Foot Ankle Int. 27(11):887–93
Machacek F Jr, Easley ME, Gruber F, Ritschl P, Trnka HJ (2005) Salvage of the failed Keller resection arthroplasty. Surgical technique. J Bone Joint Surg Am. 87 Suppl 1(Pt 1):86–94. Orthopaedic Hospital Gersthof, Wielemansgasse 28, 1180 Vienna, Austria. f.machacek@chello.at
Mahan KT, Downey MS, Weinfeld GD. (2003) Autogenous bone graft interpositional arthrodesis for the correction of flail toe. A retrospective analysis of 22 procedures. J Am Podiatr Med Assoc. 93(3):167–73
Moeller K, Edelmann H Interposition arthrodesis after Keller-Brandes surgery of the large toe. Unfallchirurg. 102(8):662–4
Marti RK, Schröder J. (2006) Arthrodesis of small joints, illustrated by the carpometacarpal joint of the thumb. Oper Orthop Traumatol. 18(1):57–65
Vienne P, Sukthankar A, Favre P, Werner CM, Baumer A, Zingg PO (2006) Metatarsophalangeal joint arthrodesis after failed Keller-Brandes procedure. Foot Ankle Int. 27(11):894–901
Literatur zu Kapitel 7.3
Austin DW, Leventeen EO (1981) A new osteotomy for hallux valgus. Clin Orthop 157:25
Corless JR (1976) A modification of the Mitchell procedure. J Bone Joint Surg 55 B:138
Engelhardt P (2001) Orthopädische Fußchirurgie. Steinkopf, Darmstadt, S 103–131
Schede F (1927) Hallux valgus, Hallux flexus und Fußsenkung. Z Orthop 48:564
Shereff MJ (1987) Extraosseous and intraosseous arterial supply to the first metatarsal and metatarsophalangeal joint. Foot Ankle 8:81
Wülker N (2002) Zehendeformitäten. In: Wirth CJ (Hrsg) Orthopädie und orthopädische Chirurgie. Fuß. Thieme, Stuttgart, S 174–196
Literatur zu Kapitel 7.4
Barouk LS (1992) Notre experience de l’osteotomie scarf des premier et cinquième metatarsiens. Med Chir Pied 8.2:67–84
Barouk LS (2003) Forefoot reconstruction. Springer, Paris
Barouk LS (2006) Persönliche Mitteilung anlässlich des DAF Kongresses 2006, Heidelberg
Barouk LS (2007) The Scarf first metatarsal osteotomy in the correction of hallux valgus deformity. Interact Surg 2:2–12
Berg RP, Olsthoorn PG, Pöll R (2007) Scarf osteotomy in hallux valgus: a review of 72 cases. Acta Orthop Belg: 73
Borrelli AH, Weil LS (1991) Modified scarf bunionectomy: our experience in more than one thousand cases. J Foot Surg 30:609–622
Burutaran JM (1976) Hallux valgus y cortedad anatomica del primer matatarsano. Act Med Chir Pied XIII: 262–266
Coughlin MJ (1997) Hallux valgus in men: Effect of the distal articular angle on hallux valgus correction. Foot Ankle Int 18:463–470
Crevoisier X, Mouhsine E, Ortolano V, Udin B, Dutoit M (2001) The scarf osteotomy for the treatment of hallux valgus deformity: a review of 84 cases. Foot Ankle Int 22:970–976
Dereymaeker G (2000). Scarf osteotomy for correction of hallux valgus. Surgical technique and results as compared to distal chevron osteotomy. Foot Ankle Clin 5:513–524
Engelhardt P (2001) Orthopädische Fußchirurgie, Steinkopff, Darmstadt
Jones S, Al Hussainy HA, Ali F, Betts RP, Flowers MJ (2004) Scarf osteotomy for hallux valgus. J Bone Joint Surg 86B:830–836
Meyer M (1926) Eine neue Modifikation der Hallux-valgus-Operation. Zbl Chir 53:3215–3268
Sabo D, Buchner M (2004) Die Behandlung des Hallux-valgus-Syndroms mit Scarf-Osteotomie, Akin-Osteotomie und Weil-Osteotomie. FussSprungg 2:76–84
Waldecker U (2004) Lateral release in hallux valgus surgery: comparison of two approaches. Foot Ankle Surg 10:195–199
Weil LS (2000) Scarf osteotomy for correction of hallux valgus. Historical perspective, surgical technique, and results. Foot Ankle Clin 5:559–580
Literatur zu Kapitel 7.5
Coughlin MJ, Carroll PJ (2007) Hallux valgus: Demographics, Etiology and Radiographic Assessment. Foot Ankle Int 28:759–777
Coughlin MJ, Jones CP (2007) Hallux Valgus and First Ray Mobility – A Prospective Study. JBJS 89-A:1887–1898
Coughlin MJ, Smith BW (2008) Hallux Valgus and First Ray Mobility-Surgical Technique. JBJS 90-A, Suppl 2:153–170
Easley ME, Kiebzak GM, Davis WH, Anderson RB (1996) Prospective, randomized comparison of proximal crescentic and proximal chevron osteotomies for correction of Hallux valgus. Foot Ankle Int 17:307–316
Gallentine JW, DeOrio JK, DeOrio MJ (2007) Bunion Surgery Using Locking-Plate Fixation of Proximal Metatarsal Chevron Osteotomies. Foot Ankle Int 28:361–368
Jones C, Coughlin MJ, Villadot R, Golano P (2005) Proximal Crescentic Metatarsal Osteotomy: The Effect of Saw Blade Orientation on First Ray Elevation. Foot Ankle Int 26:152–165
Lee K-B, Seo C-Y, Hur C-I, Moon E-S, Lee J-J (2008) Outcome of Proximal Chevron Osteotomy for Hallux Valgus With and Without Transverse Kirschner Wire Fixation. Foot Ankle Int 29:1101–1110
Lee W-C, Kim Y-M (2007) Correction of Hallux Valgus Using Lateral Soft- Tissue Release and Proximal Chevron Osteotomy Through a Medial Incision. JBJS 89-A, Suppl. 3:82–89
Mann RA, Rudicel S, Graves SC (1992) Repair of hallux valgus with a distal soft tissue procedure and proximal metatarsal osteotomy. JBJS 74-A:124–129
McCarthy AD, Davies MB, Wembridge KR, Blundell C (2008) Three- Dimensional Analysis of Different First Metatarsal Osteotomies in a Hallux Valgus Model. Foot Ankle Int 29:606–612
Myerson MS (2000) Hallux valgus. In: Myerson MS (ed) Foot and Ankle Disorders, Vol 2. Saunders, Philadelphia, pp 213–288
Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H (2008) Proximal Metatarsal Osteotomy for Hallux Valgus: Comparison of Outcome for Moderate and Severe Deformities. Foot Ankle Int 29: 64–670
Saragas NP (2009) Proximal Opening-Wedge Osteotomy of the First Metatarsal for Hallux Valgus Using a Low Profile Plate. Foot Ankle In. 30:976–980
Shurnas PS, Watson TS, Crislip TW (2009) Proximal First Metatarsal Opening Wedge Osteotomy with a Low Profile Plate. Foot Ankle Int 30:865–872
Tanaka Y, Takakura Y, Kumai T, Sugimoto K, Taniguchi A, Hattori K (2008) Proximal Spherical Metatarsal Osteotomy for the Foot with Severe Hallux Valgus. Foot Ankle Int 29:1025–1030
Thomas M (2009) Die proximale Verschiebeosteotomie mit winkelstabiler Plattenosteosynthese zur Korrektur der fortgeschrittenen Hallux valgus Deformität. FussSprungg 7:14–21
Thordarson DB, Leventen EO (1992) Hallux valgus correction with proximal metatarsal osteotomy: two year follow up. Foot Ankle Int 13:321–326
Trnka H-J, Hofstaetter SG ‚Easley ME (2009) Intermediate-Term Results of the Ludloff Osteotomy in One Hundred and Eleven Feet. JBJS 91-A, Suppl 2:156–168
Walther M, Menzinger F, Dreyer F, Mayer B (2008) Die proximale Open-Wedge-Osteotomie mit winkelstabiler Plattenosteosynthese zur Korrektur der Spreizfußdeformität mit Hallux valgus. Oper Orthop Traumatol 20:452–462
Literatur zu Kapitel 7.6
Coetzee JC, Wickum D (2004) The Lapidus Procedure: a prospective Cohort Outcome Study. Foot Ankle Int 25:526–531
Coetzee JC, Resig SG, Kuskowski M, Saleh KJ (2004) The Lapidus Procedure as Salvage After Failed Surgical Treatment of Hallux Valgus – Surgical technique. JBJS 86-A, Suppl 1:30–36
Coughlin MJ, Jones CP (2007) Hallux Valgus and First Ray Mobility – A Prospective Study. JBJS 89-A:1887–1898
Fuhrmann RA (2005) Die Korrekturarthrodese des ersten Tarsometatarsalgelenks zur Behandlung des fortgeschrittenen Spreizfußes mit Hallux-valgus Fehlstellung. Oper Orthop Traumatol 17:195–210
Gruber F, Sinkov VS., Bae SY, Parks BG, Schon LC (2008) Cross Screws Versus Dorsomedial Locking Plate with Compression Screw for First Metatarsocuneiform Arthrodesis: A Cadaver Study. Foot Ankle Int 29:927–930
Lapidus PW (1934) Operative Correction of the metatarsus varus primus in hallux valgus, Surg Gynaecol Obstet 58:183–191
Lapidus PW (1960) The authors bunion operations from 1931 to 1959. Clin Orthop 16:119–135
Myerson M, Allon S, Mc Garvey W (1992) Metatarsocuneiform arthrodesis for management of Hallux valgus and metatarsus primus varus. J Foot Ankle Surg 13:107–116
Rink-Brüne O (2004) Lapidus Arthrodesis for Management of Hallux Valgus – A Retrospective Review of 106 Cases. J Foot Ankle Surg 43:290–295
Sangeorzan BJ, Hansen ST Jr (1989) Modified Lapidus Procedure for Hallux valgus. Foot Ankle 9:262–266
Scranton PC, Coetzee JC, Carreira D (2009) Arthrodesis of the First Metatarsocuneiform Joint: A Comparative Study of Fixation Methods. Foot Ankle Int 30:341–345
Simons P, Nass K, Wenisch A (2009) Die Lapidusarthrodese – Fixation mit plantarer Platte und primäre Vollbelastung. Fuß- und Sprunggelenk 7:173–177
Thompson IM, Bohay DR (2005) Fusion Rate of First Tarsometatarsal Arthrodesis in the Modified Lapidus Procedure and Flatfoot Reconstruction. Foot Ankle Int 26:698–703
Walther M, Simons P, Nass K, Röser A (2011) Die Arthrodese des Tarsometatarsal-I-Gelenkes mit einer plantaren Zuggurtungsosteosynthese. Operative Orthopädie und Traumatologie 23:52–59
Wanivenhaus A (1998) Hallux valgus: Arthrodese des ersten Tarsometatarsalgelenks und Osteotomie des Kuneiforme mediale. In: Wülker N, Stephens M, Cracchiolo A III (Hrsg) Operationsatlas Fuß- und Sprunggelenk. Enke, Stuttgart, S 35–41
Literatur zu Kapitel 7.7
De Prado M, Ripoll PL, Golanó P (2003) Introducción. In: De Prado M, Ripoll PL, Golanó P (Hrsg). Cirugía percutánea del pie. Técnicas quirúrgicas. Indicaciones. Bases anatómicas. Masson
Erdle Ch (2009) Ergebnisse nach perkutaner minimal-invasiver Vorfußkorrektur bei Hallux valgus. Inauguraldissertation der Universität Um
Isham SA (1997–2007) Minimal invasive foot and ankle surgery. In: Isham SA & Associates. Site content: Coeur d’Alene Foot and Ankle Clinic, http://www.drisham.com
Magnan B, Bortolazzi R, Samaila E, Pezzè L, Rossi N, Bartolozzi P (2006) Percutaneous distal metatarsal osteotomy for correction of hallux valgus. Surgical technique. J Bone Joint Surg Am 88, Suppl 1 Pt 1:135–148
Pehlivan O, Akmaz I, Solakoglu C, Kiral A, Kaplan H (2004) Proximal oblique crescentic osteotomy in hallux valgus. J Am Podiatr Med Assoc 94:43–46
Robinson AH, Cullen NP, Chhaya NC, Sri-Ram K, Lynch A (2006) Variation of the distal metatarsal articular angle with axial rotation and inclination of the first metatarsal. Foot Ankle Int 27:1036–1040
Thordarson D, Ebramzadeh E, Moorthy M, Lee J, Rudicel S (2005) Correlation of hallux valgus surgical outcome with AOFAS forefoot score and radiological parameters. Foot Ankle Int 26:122–127. Erratum in: Foot Ankle Int (26. April 2005) Table of Contents
Trnka HJ, Zembsch A, Easley ME, Salzer M, Ritschl P, Myerson MS (2000) The chevron osteotomy for correction of hallux valgus. Comparison of findings after two and five years of follow-up. J Bone Joint Surg Am 82-A:1373–1378
Literatur zu Kapitel 7.8
Akin OF (1925) The treatment of hallux valgus: a new operative procedure and its results. Med Sentinel 33:678–679
Barouk LS (1998) Hallux valgus: Osteotomie der proximalen Phalanx. In: Wülker N, Stephens M, Cracchiolo A (Hrsg) Operationsatlas Fuß und Sprunggelenk. Enke, Stuttgart, S 1–6
Barouk LS (2003) The great toe first phalanx osteotomy. In: Barouk LS (ed) Forefoot Reconstruction. Springer, Paris, S 78–88
Barouk LS, Barouk P, Baudet B, Toullec E (2005) The great toe proximal phalanx osteotomy: the final step of the bunionectomy. Foot Ankle Clin 10:141–155
Basile A, Battaglia A, Campi A (2000) Comparison of Chevron-Akin osteotomy and distal soft tissue reconstruction-Akin osteotomy for correction of mild hallux valgus. Foot Ankle Surg:155–163
Boberg JS, Menn JJ, Brown WL(1991) The distal akin osteotomy: a new approach. J Foot Surg 30:431–436
Cohen MM (2003) The oblique proximal phalangeal osteotomy in the correction of hallux valgus. J Foot Ankle Surg 42:282–289
Diebold PF (2000) Chevron Akin double osteotomy for correction of hallux valgus after the age of 60 years. Proceeding of the 30th annual meeting AOFAS, Orlando
Engelhardt P (2001) Orthopädische Fußchirurgie. Steinkopff, Darmstadt, S 101–102, 129–130
Frey C, Jahss M, Kummer FJ (1991) The Akin procedure: an analysis of results. Foot Ankle 12:1–6
Goldberg I, Bahar A, Yosipovitch Z(1987) Late results after correction of hallux valgus deformity by basilar phalangeal osteotomy. J Bone Joint Surg Am 69:64–67
Jarde O, Trinquier-Lautard JL, Gabrion A, Ruzic JC, Vives P (1999) Hallux valgus treated by first metatarsal scarf osteotomy. A series of 50 cases with a minimum follow up of two years. Rev Chir Orthop Reparatrice Appar Mot 85:374–380
Plattner PF, Van Manen JW(1990) Results of Akin type proximal phalangeal osteotomy for correction of hallux valgus deformity. Orthopedics 13:989–996
Sabo D (2007) Correction osteotomy of the first phalanx of the great toe (Akin osteotomy) Interact Surg 1:66–70
Sabo D, Buchner M (2004) Die Behandlung des Hallux-valgus-Syndromes mit Scarf-Osteotomie, Akin-Osteotomie und Weil-Osteotomie. FussSprungg 2:76–84
Shelfman BS (1999) Akin osteotomy with horizontal interosseous wire-loop fixation. J Am Podiatr Med Assoc 89:194–198
Steinböck G, Leder K (1988) The Akin-Osteotomy. A new method for surgery of hallux valgus. 1-year results of a covered surgical method. Z Orthop Ihre Grenzgeb 126:420–424
Tollison ME, Baxter DE (1997) Combination chevron plus Akin osteotomy for hallux valgus: should age be a limiting factor? Foot Ankle Int 18:477–481
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Berlin Heidelberg
About this chapter
Cite this chapter
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
Download citation
DOI: https://doi.org/10.1007/978-3-642-25876-3_7
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-25875-6
Online ISBN: 978-3-642-25876-3
eBook Packages: Medicine (German Language)