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TARO 17 (2009) - pé


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17. No hálux rigidus, a alteração primária da cartilagem articular situa-se na face

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A) Dorsal da falange proximal
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B) Dorsal da cabeça do 1º metatarsal
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C) Plantar da falange proximal
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D) Plantar da cabeça do 1º metatarsal
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TARO 17 (2009) - pé
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PostPosted: 25/8/2011, 19:05 Rate Post

Hallux rigidus, a term coined by Cotterill in 1888, refers to limitation of motion of the metatarsophalangeal joint of the great toe. Although he did not call it hallux rigidus, in 1887 Davies-Colley reported the first resection of the base of the proximal phalanx for this disorder, which he called hallux flexus because of the flexion posture of the metatarsophalangeal joint with the foot plantigrade and the limited extension of the joint (Fig. 78-85). Although understanding of the condition has advanced through radiographic and histological techniques, the pathogenesis of hallux rigidus is still not clearly defined, but its unrelenting destructive course is well appreciated. Cartilage damage is believed to initiate the synovitis, which leads to further cartilage destruction, osteophyte proliferation, and subchondral bone destruction.
The process may begin in adolescence when a single traumatic event at the metatarsophalangeal joint damages the dorsal articular surface of the metatarsal head. Repeated microtrauma also may cause articular cartilage damage. Other suggested causes include osteochondritis dissecans of the first metatarsal head secondary to an osteochondral fracture over the dorsal convexity of the joint surface, hyperextension of the first metatarsal, an abnormally long first metatarsal, and severe pronation of the foot. According to Thompson et al., adult hallux rigidus most often is caused by degenerative arthritis of the first metatarsophalangeal joint, whereas in adolescents, hallux rigidus usually results from localized cartilage damage to the first metatarsal head.

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