関節リウマチに伴う前足部変形に対する外科的治療成績

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概要

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• Objective: There are many surgical techniques applicable to rheumatoid forefoot deformities. The purpose of this study was to determine the results of arthrodesis of the first metatarsophalangeal (MTP) joint with resection arthroplasty of the metatarsal head of the second through fifth toes.Methods: Seven feet in 13 patients with a minimum of 3 years postoperative follow-up were evaluated. Clinical examination, radiological measurements, and the occurrence of complications were used to evaluate the results. Forefoot pain, footwear status, walking performance, plantar callus, and patient satisfaction were examined and classified into four grades. The hallux-valgus angle, M1M2 angle, and M1M5 angle were measured preoperatively, 3 weeks postoperatively, and at final follow-up. Complications included screw cutout, toe necrosis, and superficial infection.Results: On clinical evaluation, forefoot pain, walking performance, and patient satisfaction were rated as excellent or good in most cases. Radiographic measurement of the hallux-valgus angle and M1M2 angle showed significant improvement 3 weeks postoperatively and also at the last follow-up compared with the preoperative value. In contrast, the M1M5 angle was significantly different between pre-operative and final follow-up measurements only.Conclusion: The outcome of this operation suggests the effectiveness of arthrodesis of the MTP joint of the great toe and resection arthroplasty of the metatarsal head of the lesser toes for rheumatoid forefoot deformities.

• 日本関節病学会の論文

日本関節病学会 | 論文

• 関節リウマチ患者における手術と機能回復
• 低出力超音波刺激(LIPUS)および線維芽細胞増殖因子(FGF-2)の骨形成促進作用におけるヒアルロン酸(HA)の影響
• 変形性関節症に対するグルコサミン・コンドロイチンの有用性 (第36回[日本関節病]学会寄稿)
• 人工膝関節再置換術の経験--脛骨結節骨切り術の適応と合併症について
• RA頚椎病変に対する上位頚椎後方除圧固定術の治療成績と問題点

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