Summary

大拇趾强直（拇强直）会使大拇趾跖趾关节活动受到限制，这是关节炎恶化的一种表现。时常引起大拇趾的疼痛以及跖趾关节正常活动受限，随着病情的发展，疼痛和活动受限程度均会加剧。

Stiffness of the great toe (hallux stiffness) limits the movement of the metatarsophalangeal joints of the great toe, a sign of worsening arthritis. Often cause great toe pain and metatarsophalangeal joint normal movement limitation, with the development of the disease, pain and movement limitation will intensify.

病因

Pathogeny

在许多临床病例中，拇强直的发病原因不详。拇强直的患者中大部分都是扁平足或内旋足（踝关节向内突出）。这些足部异常的患者在活动中拇趾承受了过多的压力，导致跖趾关节处形成骨性关节炎。部分拇强直可能是由于遗传导致的。相关手术记录显示：拇囊肿导致的关节融合也会形成大拇趾跖趾关节的僵硬。

In many clinical cases, the cause of thumb rigidity is unknown. Most of the patients with thumb ankylosis are flat feet or inner feet. These patients with abnormal foot movements put too much pressure on the toes, resulting in osteoarthritis at the metatarsophalangeal joints. Some thumb ankylosis may be caused by heredity. Surgical records show that arthrodesis caused by thumb cysts also results in stiffness of the metatarsophalangeal joint of the great toe.

症状

Symptom

当天气转冷或行走时，大拇趾易发生疼痛和僵直感，关节周围会发生红肿等炎症反应，臀部、膝关节、下背部会有隐痛感，形成跛行步态。

When the weather turns cold or walking, the big toe is prone to pain and stiffness, inflammation such as swelling around joints, hip, knee, lower back will have a dull pain, forming a limping gait.

治疗

Treatment

正确的治疗方案包括：定制的足部矫形器(鞋垫)、弓形底鞋靴、抗炎药物治疗，注射皮质类固醇激素，以及物理疗法。如果情况严重，则需要进行外科手术，进行关节融合术或关节置换术。

Correct treatments include customized foot orthoses (insoles), arched soles, anti-inflammatory drugs, corticosteroid injections, and physiotherapy. If the condition is serious, surgical operations should be performed for arthrodesis or joint replacement.

矫形和治疗

Orthopaedics and treatment

医生将指导您在术前术后进行以下矫形和治疗措施：

The doctor will guide you in the following orthopaedic and therapeutic procedures before and after surgery.

使用弓形底的矫形鞋靴，根据病情选择不同弓形底

Use arched bottom orthopaedic boots, choose different bow bottom according to illness condition.

足跟到足趾拱形底 为最常见的的弓形底，用来代替足踝丧失的部分屈曲灵活性。缩短迈步前行时的过度时间，也减少足踝落地时的震动，增加前行动力。适用病症：踝关节、膝关节、髋关节融合或活动受限、皮肤移植、肌肉皮瓣、足部创伤或溃疡、严重的足踝关节炎、爪状趾或锤状趾僵硬畸形、高弓足或足局部截肢等。

The heel-to-toe arch is the most common arch, replacing the partial flexion flexibility lost by the ankle. Shortening the excessive time of walking forward also reduces the vibration of the ankle when landing, and increases the power of the front movement. Applicable diseases: ankle joint, knee joint, hip joint fusion or limited movement, skin transplantation, muscle flap, foot trauma or ulcer, severe ankle arthritis, claw toe or hammer toe stiffness deformity, high arch foot or local amputation of foot, etc.

双弓形底 可以轻微提高（小于5度）脚在起步或行进时髋、膝以及踝关节的弯曲度，可以针对问题部位或足底突出部分进行减负。增强脚前掌迈出时的动力，亦可减少落地时的震动，缩短迈步前行的过度时间。适用病症：中足底的异常突出、关节炎结节、足中弓受压疼痛、夏科足等。

Double arched soles can slightly increase (less than 5 degrees) the flexibility of the hip, knee and ankle joints of the foot at the start or march, and can be used to reduce the load on the problematic area or plantar protrusion. Enhance the power of the forefoot when striding, can also reduce the vibration when landing, shorten the excessive time of striding forward. Applicable diseases: abnormal prominence of middle foot, arthritis nodule, pain in foot arch, and summer foot.

负足跟弓形底 通过增加后跟负重来对中足和前掌进行减负。适用病症：前掌趾创伤、跖骨突出疼痛、前掌皮肤硬结、踝关节背曲受限等（因此结构与正常踝关节相悖，所以患者足踝必须有部分背曲能力，且足跟部能够承受从中足和前掌转移来的负重）

The heel of the negative heel will reduce the weight of the middle and forefoot by increasing the heel negative weight. Applicable ailments: forefoot and toe trauma, metatarsal protrusion pain, forefoot skin hardening, ankle dorsal curvature limitation, etc. (therefore the structure of the normal ankle, so the patient must have a part of the ankle dorsal curvature ability, and the heel can withstand the weight transferred from the middle foot and forefoot)

温和弓形底 可以提供跖骨减负，减少足踝和中足的压力，提高前行动力。适用病症：跖骨疼痛、后跟创伤、高弓足疼痛、踝关节疼痛、足趾截肢、扁平足疼痛或大拇趾僵直等。

Gentle arched base can provide metatarsal burden, reduce the pressure of the ankle and middle foot, and improve the driving force. Applicable diseases: metatarsal pain, heel trauma, high arch pain, ankle pain, toe amputation, flat foot pain or big toe stiffness, etc.