Reconstruction of Rheumatoid Forefoot Deformities

Lee, Kyung Tai; Kim, Dong Hyung; Choi, Kyeong Jin

Abstract

Rheumatoid arthritis can result in progressive deformity of the forefoot, which leads to marked limitation in shoe wear, significant pain, and substantial diminution in standing and walking ability. Twenty feet of seventeen patients with severe forefoot deformities underwent surgical correction hy means of first metatarso-phalangeal arthrodesis and resection arthroplasties of the lesser M-P joints from May, I 994 to March, l996. The results were as follows; l. Suhjective improvement in pain, standing and walking ability, and shoe wear was excellent in fifteen (7~5%) feet, good in three (l5%), fair in one (5%), and poor in one (5%) foot. 2. The average hallux valgus angle (HVA), 1st intermetatarsal angle (IMA) were improved from 46.7 and 13.7 to 11. 1 and 8.2 degree individuaIly. 3. The average angle of dorsiflexion after the first metatarsophalangeal (MP) joint arthrodesis was 12.9 degree. 4. Complications of the procedures were minimal; three delayed wound healing, one non-displaced fracture of fusion site due to trauma, one malunion of the 1st MTP joint, one recurrence of the fibular deviation of the lesser toes.