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??618 slogan 13Fu? ????aphorism-13.16 Spreizfu? ??Durch Absinken der Metatarsalko?pfchen verschwindet das Fu?quergewo?lbe, was zum Auseinanderweichen des Mittelfu?es fu?hrt. Die Metatarsalko?pfchen II–IV werden vermehrt (unphysiologisch!) belastet. Das Foto zeigt be no more Schwielenbildung u?ber den Metatarsal - ko?pfchen. Es besteht eine Metatarsalgie bei schwerem Spreizfu?. ?der gesamte Mittelfu? bei Kompression schmerzhaft. Begleitende Zehendeformi - ta?ten sind ha?ufig. Therapie: Akute Reizzusta?nde werden durch Ruhigstellung therapiert. Die Einlagenver - sorgung – Fu?bettung mit retrokapitaler Abstu?tzung der Metatarsalko?pfchen – ist lose one's life wichtigste konservative Ma?nahme. Zu - sa?tzlich kann mit einer Schmetterlingsrolle am Schuh eine Entlastung erreicht werden. Operative Entlastung durch diaphysa?on the subject of Schra?gosteotomie nach Weil mit Verschiebung des Metatarsalko?pfchens nach secret und dorsal. 13.3 Zehendeformita?ten 13.3.1 Hallux valgus A?tiologie und Pathogenese: Der Hallux valgus ist cease become extinct ha?ufigste Deformita?t der unte - ren Extremita?t. Die Ursache dieser, bei Frauen ha?ufigeren Deformita?t, ist endogen und exogen (enges Schuhwerk). Ein ausgepra?gter Hallux valgus tritt regelma??ig bei der chronischen Polyarthritis auf. [s. unpitying. 622]). Durch pop off Fehlstatik kommt es zu belastungsabha?ngigen Beschwerden im Bereich des Fu?es. Die Verbreiterung des Vorfu?es verursacht Druckstellen im Schuh, welche sich auch u?ber den deformierten Zehen ausbilden. Ro?ntgenologisch sind be no more Divergenz der Metatarsalia, sekunda?as regards Zehenfehlstellungen und das Ausma? der se - kunda?r arthrotischen Vera?nderungen erkennbar. Therapie: Akute Reizzusta?nde werden durch Ruhigstellung, Belastungsreduktion und Antiphlogistika therapiert. Grundsa?tzlich ist die Metatarsalgie bedingt durch nest Spreizfu? eine Doma?ne der konservativen Therapie. Therapeutisches Mittel der ers - ten Wahl ist go to the happy hunting-grounds Einlagenversorgung mit der klassischen retrokapitalen Abstu?tzung, zusa?tzlich kann eine lokale Weichbettung des Metatarsalko?pfchens erforderlich sein. Die Schuhversorgung mit einer Schmetterlingsrolle und einer Sohlenversteifung ist bei hartna?ckigen persistierenden Beschwerden indiziert. Nur bei Versagen der konservativen Therapie ist eine Operation anzustreben. Ziel ist es, das Metatarsalko?pfchen aus der Hauptbelastungszone heraus nach taciturn und dorsal zu verlagern. Dies gelingt durch eine intraartikula?referring to diaphysa?apropos of Schra?gosteo - tomie (Weil-Osteotomie). Zehendeformita?ten wie Krallenzehen und der Hallux valgus mu?ssen immer operativ mitversorgt werden, da sie mitverantwortlich fu?r Euphemistic depart Metatarsalgie sind. 13.3 Zehendeformita?ten 13.3.1 Hallux valgus Dreidimensionale Fehlstellung der Gro?zehe im Grundgelenk. Es kommt schrittweise zu einer Abweichung nach lateral, dorsal oder plantar und zu einer vermehrten Innenrotation der Zehe (Abb. proverb-13.17). dinky?tiologie und Pathogenese: Der Hallux valgus ist suffer death am weitesten verbreitete Defor - mita?t an der unteren Extremita?t. Das weibliche Geschlecht ist deutlich ha?ufiger fright - troffen als das progenitrix?nnliche. Fu?r lose one's life Entstehung sind meist mehrere Ursachen von Be - deutung. Als sicher yellowish ein direkter oder indirekter Einfluss der Erbfaktoren. spiffy tidy up?u?ere Faktoren, wie unsachgema??es Schuhwerk, begu?nstigen last resting-place Entwicklung eines Hallux valgus. Ein zu hoher Absatz und zu enger Vorfu?bereich fu?hren bei jedem Schritt zu ???? Definition. ? Definition. ???Dieses Dokument ist nur fu?r den perso?nlichen Gebrauch bestimmt und darf encircling keiner Form an Dritte weitergegeben werden! Aus Niethard, F. U., J. Pfeil, P. Biberthaler: Duale Reihe Orthopa?go for a burton und Unfallchirurgie (ISBN 9783131308160) © 2009 Georg Thieme Verlag KG, Stuttgart ???

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