title: Pan-metatarsophalangeal joint arthrodesis for the severe rheumatoid forefoot deformity.
abstract: The standard approach for correction of severe painful rheumatoid forefoot deformities has involved resection of the metatarsal heads with realignment of the lesser toe deformities and first metatarsophalangeal joint (MTPJ) arthrodesis. Modifications of this procedure may include a pan-metatarsal head resection, including the first metatarsal head, or resection of the lesser metatarsal heads in conjunction with an interpositional arthroplasty of the first MTPJ. The authors describe a novel surgical approach that involves the correction of severe rheumatoid forefoot deformities through a pan-MTPJ arthrodesis. Arthrodesis of all five MTPJs for the surgical treatment of the painful rheumatoid forefoot deformity with chronic plantar callosities and dislocated digits has yet to be reported in the scientific literature. The goal of this article is to provide the treating physician with another alternative and safe surgical approach when dealing with the painful rheumatoid forefoot deformity.
authors.affiliation: Division of Podiatric Medicine and Surgery, Department of Orthopaedic Surgery, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MCS 7776, San Antonio, TX 78229, USA.
authors.forename: Luke C
authors.initials: LC
authors.lastname: Jeffries
authors.forename: Roberto H
authors.initials: RH
authors.lastname: Rodriguez
authors.forename: John J
authors.initials: JJ
authors.lastname: Stapleton
authors.forename: Thomas
authors.initials: T
authors.lastname: Zgonis
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D001174:Arthrodesis / Q000266:history / Q000379:methods*; D005531:Foot Deformities, Acquired / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D049673:History, 20th Century; D006801:Humans; D008682:Metatarsal Bones / Q000601:surgery; D008683:Metatarsophalangeal Joint / Q000601:surgery*; D011032:Podiatry / Q000266:history / Q000379:methods*; D011182:Postoperative Care; D016896:Treatment Outcome