Long-term results after metatarsal head resection in the treatment of rheumatoid arthritis.
BACKGROUND
In this retrospective study, both the patients' and surgeons' satisfaction with resection of the first through fifth metatarsal heads for long-standing rheumatoid forefoot deformity was evaluated.


METHODS
Thirty-four patients (56 feet) had first through fifth metatarsal head resection. After a mean time of 5.3 years, 39 feet (69.6%) (26 patients) were examined clinically and radiographically.


RESULTS
The complication rate was 14% (8 of 56). There were four superficial and four deep wound infections. Plantar pressure pain under the resected metatarsal heads occurred in six feet. Most patients rated their cosmetic and functional results as good. Eighteen percent of patients (6 of 34) were satisfied and 78% (26 of 34) were satisfied with reservations. Thirty-three percent of patients (11 of 34) were pain free and 53% (18 of 34) had mild pain. The surgeons assessment of the patients' anatomical correction (cosmesis) was good in 90% (50 of 56) and poor in 10% (6 of 56).


CONCLUSIONS
Our results, which are comparable to those of other studies, confirm the success of metatarsal head resection for the treatment of inflammatory forefoot destruction in rheumatoid arthritis to correct deformity, reduce pain, improve ambulation, and offer the patient a greater variety of shoewear.
Reize
Patrik
P
Orthopädische Universitäts und Poliklinik Tübingen, Hoppe-Seyler Str 3, D-72076 Tübingen, Germany. patrik.reize@med.uni-tuebingen.de
Leichtle
Carmen Ina
CI
Leichtle
Ulf Gunther
UG
Schanbacher
Jörg
J
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005531:Foot Deformities, Acquired / Q000000981:diagnostic imaging / Q000601:surgery*; D005545:Forefoot, Human / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011182:Postoperative Care; D011859:Radiography; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking