PMID: 22568326May 10, 2012Paper

Rheumatoid forefoot reconstruction with first metatarsophalangeal fusion and arthroplasty of lesser metatarsal heads

Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery
Xiaojun DuanXu Peng

Abstract

To evaluate the surgical treatment and effectiveness of rheumatoid forefoot reconstruction with arthrodesis of the first metatarsophalangeal joint and arthroplasty of lesser metatarsal heads. Between January 2007 and August 2009, 7 patients with rheumatoid forefoot were treated by reconstruction with arthrodesis of the first metatarsophalangeal joint and arthroplasty of lesser metatarsal heads. They were all females with an average age of 62 years (range, 56-71 years) and with an average disease duration of 16 years (range, 5-30 years). All patients manifested hallux valgus, hammer toe or mallet toe of 2-5 toes, 5 feet complicated by subluxation of the second metatarsophalangeal joint. The improved American Orthopaedic Foot & Ankle Society (AOFAS) score was 36.9 +/- 6.4. The hallux valgus angle was (46 +/- 5) degrees, and the intermetarsal angle was (12 +/- 2) degrees by measuring the load bearing X-ray films preoperatively. All incisions healed by first intention after operation. The X-ray films showed bone fusion of the first metatarsophalangeal joint at 3-4 months after operation. Seven patients were followed up 2.9 years on average (range, 2-4 years), gait was improved and pain was relieved. The hallux valgus angle decrease...Continue Reading

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