Der Vorfuß bei Patienten mit rheumatoider Arthritis

Assessment of foot impairment in rheumatoid arthritis patients by dynamic pedobarography

“…We found a higher percentage of RA2 patients suffering from palpation pain in the subtalar joint compared to RA1. This may indicate a more severe inflammation and deformity and, therefore, increased hindfoot valgus during stance phase: this is reported to be the primary cause of local pain in this foot region [12,35,36].…”

First Ray Resection Arthroplasty versus Arthrodesis in the Treatment of the Rheumatoid Foot

“…12 The hallux pushing laterally affects the lesser toes 19 and the depression of the metatarsal heads cause hammer or claw toe deformity. 3,4,25 Typical symptoms are pain during the rollover process and external rotation of the foot that is used to reduce forefoot loading. The inflammatory erosion of the metatarsal heads leads to a reduction of their load-bearing area so that similar forces during gait will lead to increased local pressures.…”

“…21,22 Patients with arthrodesis reportedly tend towards less relapses than patients with a resection arthroplasty. 3 Furthermore, the cosmetic appearance after arthrodesis is considered to be better than resection arthroplasty which -in combination with the lower risk of relapse -leads to higher patient satisfaction. Finally, patients with arthrodesis appear to have a better forefoot function due to the more stable first ray that can bear more load and helps to unload the lateral toes.…”