Leprosy Patients and Hallux Valgus:First Report
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概要
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It was believed in the past that hallux valgus would not become a subject of medical treatment, since it rarely occurred in the Japanese people, although Europeans and Americans suffered from hallux valgus frequently. Recently however, hallux valgus has been observed in as many as about 30% of the Japanese, and waht is more, 80% of these are female. It has been reported that the incidence of hallux valgus in leprosy patients is 32%, but there is no sex difference indicated and no mention that hallux valgus occurs more frequently in females.In this study, we selected dry photographic plates taken between 1910 and 1951 from materials for medical study stored at Tama Zenshoen, and examined the 38 plates in which feet were photographed (96 feet of 54 patients) for complications of hallux valgus.The results showed that 7 feet of 6 patients (photographs 1, 2, 7, 8 and 9) gave some indication of having hallux valgus. After excluding cases which seemed to be due to destruction of the capitus ossa metatarsalia I accompanying perforation of the feet (photos 1, 2 and 7), however, ohly 3 feet of 2 patients (photos 7 and 9) remained. Furthermore, the hallux valgus observed in the 3 feet (2 patients) was judged to be slight to moderate and not to require medical treatment.This large difference in the incidence of complications of hallux valgus between the past and the present is thought to be due to the fact that the primary footwear in the past comprised geta (wooden clops) and zori (Japanese sandals). That is to say, a hanao should be retained between the valgus and the digitis pedis II, which must have the same effect as that of hallux valgus prevention equipment. The bandaging methods of hte past shown in photos 3, 4 and 5 also seems to have contributed to the prevention of hallux valgus. At any rate, exogenous factors such as footwear are thought to be the principal cause of the occurrence of hallux valgus in leprosy patients, rather than unbalanced muscular strength in the feet destruction of the horizontal arch due to motor paralysis of leprosy.
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