外反拇指

bunion hallux valgus

親指の付け根の内側の突出部分が靴に当たるなどの刺激を受けて、結節・バニオンと言われる皮下滑液包炎を生じて、腫れや熱感、疼痛、炎症を伴うことがあります。　突出部には親指に行く神経が通っているため、その神経が圧迫されることにより親指にしびれや痛みがでることもあります。症例写真のように、足の形態異常となると、足のバランスが崩れ、歩きにくく疲れ易いと言った症状や、足のアーチの低下にもつながります。症例写真の患者様は、最初は親指の付け根が痛くなり、数年かけて、母趾が「く」の字状に外側に曲がって、人差し指と当たって痛くなり、足の裏に痛いタコまで出来てしまった。痛みが抜けた頃に、母趾が人差し指（第2趾）の下にもぐりこみ、さらに痛みがひどくなってきた。外反母趾になりやすい特徴は、中年期以降だと履物に加えて、肥満と筋力低下なども原因となります。健常な足には縦のアーチだけでなく横のアーチがあります。外反母趾ではこれらのアーチが崩れて偏平足なると外反母趾になりやすくなります。今回の治療では、くの字に曲がり、引っ張られている筋の緊張を緩めました。抜本的な治療ではなく、対処的な治療になりますが、疼痛は緩和しています。

The medial protrusion at the base of the thumb may be irritated, such as by hitting a shoe, causing a subcutaneous bursitis called a nodule or bunion, which may be accompanied by swelling, heat, pain, and inflammation.　Because the protrusion has a nerve that goes to the thumb, compression of that nerve can also cause numbness and pain in the thumb. As shown in the case photo, foot dysplasia can lead to imbalance in the foot, making it difficult to walk and making the feet tired, and also to a decrease in the arch of the foot. The patient in the case photo started out with pain at the base of her thumb, and over the years, her big toe bent outward in a "ku" shape, causing pain when it hit her index finger, and she even developed painful calluses on the bottom of her foot. When the pain subsided, the big toe tucked under the index finger (second toe), and the pain became even worse. Characteristics that predispose to bunions include obesity and muscle weakness, in addition to footwear after middle age. A healthy foot has horizontal arches as well as vertical arches. When these arches collapse and the feet become flat, the big toe is more susceptible to bunions. In this treatment, we loosened the tension of the muscles that are pulling on the big toe. This is not a drastic treatment, but rather a coping treatment, but the pain has been alleviated.