Joint-preserving surgery in rheumatoid forefoot: preliminary study with more-than-two-year follow-up.
The authors propose a joint-preserving surgery for rheumatoid forefoot deformities as an alternative to the "classic" surgical approach to the rheumatoid forefoot. The main principle is joint preservation by shortening osteotomies of all the metatarsals performed at the primary location of the rheumatoid forefoot lesions, namely the metatarsophalangeal (MTP) joints and metatarsal heads. A scarf osteotomy is normally performed on the first ray. A Weil osteotomy is performed on the lesser metatarsals. Excellent correction of the hallux valgus deformity in the rheumatoid forefoot can be achieved with a scarf osteotomy in 92% of cases without the need for MTP joint arthrodesis. Similarly, 86% of the lateral metatarsal heads can be preserved using Weil osteotomies.
Barouk
Louis Samuel
LS
Polyclinique de Bourdeaux, 151 Rue du Tondu, 33000 Bordeaux, France. samuel.barouk@wanadoo.fr
Barouk
Pierre
P
D001172:Arthritis, Rheumatoid / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D033023:Foot Joints / Q000601:surgery*; D005545:Forefoot, Human / Q000601:surgery*; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D016896:Treatment Outcome