Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Result of Joint Preserving Surgery Using Axial Shortening Metatarsal Osteotomy for the Treatment of Severe Hallux Valgus and Claw Toes Deformity in Advanced Rheumatoid Arthritis

류마티스 관절염에 의한 고도의 무지 외반증과 소족지 갈퀴족 변형에 대한 중족골 종축 감압 절골술을 이용한 관절 보존술의 결과

  • Nam, Il-Hyun (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Ahn, Gil-Yeong (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Moon, Gi-Hyuk (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Lee, Yeong-Hyeon (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Choi, Seong-Pil (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Kim, Ho-Gyu (Department of Orthopedic Surgery, Pohang St. Mary's Hospital) ;
  • Oh, Dong-Ho (Department of Division of Rheumatology, Pohang St. Mary's Hospital)
  • 남일현 (포항성모병원 정형외과) ;
  • 안길영 (포항성모병원 정형외과) ;
  • 문기혁 (포항성모병원 정형외과) ;
  • 이영현 (포항성모병원 정형외과) ;
  • 최성필 (포항성모병원 정형외과) ;
  • 김호규 (포항성모병원 정형외과) ;
  • 오동호 (포항성모병원 류마티스 내과)
  • Received : 2012.01.15
  • Accepted : 2012.02.14
  • Published : 2012.03.15
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Abstract

Purpose: The purpose of this study is to evaluate the effect of axial shortening metatarsal osteotomy on the treatment of advanced rheumatoid arthritis patients with severe hallux valgus and claw toe deformity of lesser toes which is used for preserving the metatarsophalangeal joint. Materials and Methods: From January 2005 to June 2009, 18 cases of axial shortening metatarsal osteotomy in advanced rheumatoid arthritis were reviewed ; all of them followed up for more than 2 years after surgical procedures and the mean follow up period was 3.4 years. We performed axial shortening Scarf osteotomy and Akin osteotomy for hallux valgus and Weil osteotomy with soft tissue release for claw toe of lesser toes, respectively. We measured preoperative and postoperative hallux valgus angle, each metatarsal shortening length and the range of motion of the metatarsophalangeal joints through radiographic and clinical examination and compared them each other. Clinical results were evaluated by American Orthopedic Foot and Ankle Society (AOFAS) score and subjective satisfaction of the patients. Results: The hallux valgus angle was reduced from the preoperative mean value of 44.8 degree to 9.0 degree postoperatively and the range of motion of the metatarsophalangeal joint of great toe and lesser toes was increased from the mean of 21.7 degree and 11.0 degree preoperatively to 38.0 degree and 32.5 degree, respectively at postoperation. Also, the mean AOFAS score was improved from 26.5 points to 67.4 points. Conclusion: Axial shortening osteotomy is a useful method to correct the deformity and preserve the metatarsophalangeal joint for severe hallux valgus and claw toe deformity in advanced rheumatoid arthritis.

Keywords

References

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