Evaluation of Clayton's operation for RA foot.

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We have performed resection arthroplasty of the metatarsophalangeal joint by Clayton's procedure for correction of foot in rheumatoid arth-ritis (RA) patients. In the present study, the effect of this surgical treatment was evaluated by static and dynamic analyses of motor function. The subjects used in this study were 8 RA patients (13 joints) undergoing Clayton's operation, all female with an age range of 38-65 years. In one of these patients (2 joints), replacement of the first metatarsophalangeal joint by Swanson's procedure was combined. The result of this surgical treatment was evaluated by both static analysis using the method of Preskale and dynamic analysis using three-demensional steteoscopic gait tracking method. Postoperative measurement of static plantar pressure by the method of Preskale showed an improved, almost uniform distribution of pressure over the sole brought about by Claiton's operation, while gait analysis revealed that the stability of gait was unsatisfactory. The gait of patients who underwent replacement of the first metatarsophalangeal joint with Swanson's prosthesis was more stable postoperatively than preoperatively.