Abstract:
OBJECTIVES:The introduction of powerful antirheumatic drugs has dramatically improved the treatment of rheumatoid arthritis (RA), leading clinicians to reconsider the benefits of joint preservation for rheumatoid forefoot deformities. We have employed joint-preserving forefoot surgeries, including rotational closing-wedge osteotomy of the first metatarsal. The aim of our study is to assess the short-term results of this procedure. METHODS:From January 2011 through December 2011, 35 feet were treated with this procedure. Subjective, functional, and radiographic outcomes were surveyed. RESULTS:The mean Japanese Society for Surgery of the Foot improved from a preoperative level of 52.6 to 68.7 postoperatively. The average hallux valgus and intermetatarsal angles improved from 47.3° preoperatively to 17.5° postoperatively, and from 16.7° preoperatively to 9.0° postoperatively, respectively. To assess the repositioning of pronation deformities of the first metatarsal, the position of the medial sesamoid was also surveyed according to the measurement system proposed by Hardy and Clapham. All feet except two were classified as grade V or higher preoperatively; 25 of these were grade IV or lower at the latest follow-up. CONCLUSIONS:Rotational closing-wedge osteotomy of the first metatarsal was beneficial for correcting forefoot deformities in RA over the short term.
journal_name
Mod Rheumatoljournal_title
Modern rheumatologyauthors
Yano K,Ikari K,Iwamoto T,Saito A,Naito Y,Kawakami K,Suzuki T,Imamura H,Sakuma Y,Hiroshima R,Momohara Sdoi
10.1007/s10165-012-0776-9subject
Has Abstractpub_date
2013-09-01 00:00:00pages
953-8issue
5eissn
1439-7595issn
1439-7609journal_volume
23pub_type
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