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Costa MT, Backer RC, Ferreira RC. Clinical and functional evaluation of forefoot reconstruction in patients with rheumatoid arthritis. Rev Bras Ortop. 2014;49(2):167-73doi: 10.1016/j.rboe.2014.03.020.
Costa, M. T., Backer, R. C., & Ferreira, R. C. (2014). Clinical and functional evaluation of forefoot reconstruction in patients with rheumatoid arthritis. Revista brasileira de ortopedia, 49(2), 167-73. https://doi.org/10.1016/j.rboe.2014.03.020
Costa, Marco Túlio, et al. "Clinical and functional evaluation of forefoot reconstruction in patients with rheumatoid arthritis." Revista brasileira de ortopedia vol. 49,2 (2014): 167-73. doi: https://doi.org/10.1016/j.rboe.2014.03.020
Costa MT, Backer RC, Ferreira RC. Clinical and functional evaluation of forefoot reconstruction in patients with rheumatoid arthritis. Rev Bras Ortop. 2014 Apr 02;49(2):167-73. doi: 10.1016/j.rboe.2014.03.020. eCollection 2014. PMID: 26229794; PMCID: PMC4511664.
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Rev Bras Ortop. 2014 Apr 02;49(2):167-73. doi: 10.1016/j.rboe.2014.03.020. eCollection 2014.

Clinical and functional evaluation of forefoot reconstruction in patients with rheumatoid arthritis.

Revista brasileira de ortopedia

Marco Túlio Costa, Ricardo Cardoso Backer, Ricardo Cardenuto Ferreira

Affiliations

  1. Department of Orthopedics and Traumatology, Fernandinho Simonsen Wing, School of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil.

PMID: 26229794 PMCID: PMC4511664 DOI: 10.1016/j.rboe.2014.03.020

Abstract

OBJECTIVE: to evaluate the long-term results from reconstruction of the forefoot in patients with rheumatoid arthritis who underwent arthrodesis of the metatarsophalangeal joint of the hallux, resection arthroplasty of the heads of the lateral metatarsals and correction of the deformities of the smaller toes through arthrodesis of the proximal interphalangeal joint or closed manipulation.

METHODS: seventeen patients (27 feet) who underwent forefoot reconstruction surgery by means of arthrodesis of the first metatarsophalangeal joint, resection of the heads of the lateral metatarsals and correction of the deformities of the smaller toes, were studied retrospectively. The mean follow-up was 68 months (12-148 months); the mean age was 52 years (range: 20-75 months); and four patients were male and 13 were female.

RESULTS: the results were classified as excellent in 17 feet, good in two, fair in four and poor in two. The mean score on the AOFAS scale was 70 points; 21 feet (78%) were found to be asymptomatic; and six feet (22%) presented some type of symptom. Three feet presented pseudarthrosis, and one of these successfully underwent revision of the arthrodesis. There was no significant difference in scoring on the AOFAS scale or in the consolidation rate, between using a plate and screws and using Kirschner wires for fixation of the arthrodesis.

CONCLUSION: arthrodesis of the first metatarsophalangeal joint with resection arthroplasty on the heads of the lateral metatarsals and correction of the deformities of the smaller toes, which was used in forefoot reconstruction in rheumatoid patients, showed good long-term results with a high satisfaction rate among the patients and clinical-functional improvement.

Keywords: Arthrodesis; Forefoot, human; Rheumatoid arthritis

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