Long-term results of the modified Hoffman procedure in the rheumatoid forefoot. Surgical technique

The Journal of Bone and Joint Surgery. American Volume
S ThomasC Senthil Kumar

Abstract

Rheumatoid arthritis commonly affects the forefoot, causing metatarsalgia, hallux valgus, and deformities of the lesser toes. Various types of surgical correction have been described, including resection of the lesser-toe metatarsal heads coupled with arthrodesis of the great toe, resection arthroplasty of the proximal phalanx or metatarsal head, and metatarsal osteotomy. We report the results at an average of five and a half years following thirty-seven consecutive forefoot arthroplasties performed in twenty patients by one surgeon using a technique involving resection of all five metatarsal heads. All patients were treated with the same technique of resection of all five metatarsal heads through three dorsal incisions. All surviving patients were asked to return for follow-up, which included subjective assessment (with use of visual analogue pain scores, AOFAS [American Orthopaedic Foot and Ankle Society] foot scores, and SF-12 [Short Form-12] mental and physical disability scores), physical examination, and radiographic evaluation. All results were satisfactory to excellent in the short term (six weeks postoperatively), and no patient sought additional surgical treatment for the feet. A superficial infection subsequently dev...Continue Reading

Citations

Jul 31, 2013·International Orthopaedics·Jan Willem K Louwerens, Joost C M Schrier
Apr 28, 2010·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Thomas S Roukis
Oct 10, 2015·Foot & Ankle International·Jun-ichi FukushiYukihide Iwamoto
Sep 4, 2007·Foot and Ankle Clinics·C Senthil Kumar, G Holt
May 18, 2010·Clinics in Podiatric Medicine and Surgery·Alfonso Anthony HaroLawrence A DiDomenico

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