AINHUM: WHAT IS AINHUM?
Definition: What is "Ainhum"?
Ainhum is a disease characterized by painful constriction of the fifth toe. This generally leads to amputation after a few years. Ainhum is more common among black African descents. It is commonly found among the blacks in West Africa, India & South America. The first recorded incidence of the disease is in 1867 by J.F. da Silva Lima. He described the disease suffered by one of the tribes in Brazil, the Nagos, who gave the disease its name. It is very rare in Europe & only a few incidences have been reported. It is also more common among those in between 20 & 50 years of age, with the average in 38 years of age. The youngest patient in record to have Ainhum is seven years old. The cause of the disease is still being studied. At present though, scientists have found that it is not caused by fungi, virus, parasite, bacteria & injury. Although it linked with walking barefoot during childhood, the disease is also found among those who have not gone barefoot. Among all the predisposing factors, race has been found to be on top of the list & thus scientists believe that it has some genetic component. Scientists believe that the disease is caused by the abnormal blood supply on the foot. Angiography of the peripheral limb has shown that the tibial artery may have become attenuated at the ankle & that there is noticeable absence of the plantar arch & branches. There are four stages of ainhum: the Grade I, wherein there is the presence of the groove; Grade II, wherein the floor of the groove is ulcerated; Grade III, wherein the bone is involved; & Grade IV wherein autoamputation occurs. In about 78% of the cases there is the presence of pain. For those in the early stage the pain may be slight & may have been caused by the pressure on the nerves. For those in the advanced stage, the pain is quite severe which is caused by chronic sepsis or fracture of the phalanx. Ainhum is commonly confused with diabetic gangrene, scleroderma, leprosy, Vohwinkle syndrome & leprosy. The pain is the symptom of the ainhum & it is a progressive condition. For the treatment of the ainhum, for the Grade I & II excision of the groove & z-plasty has been proven to relieve pain & prevent autoamputation. For the Grade III disarticulating the metatarsophanlangeal joint has been proven to be as effective.