Long-Term Results after Metatarsal Head Resection in the Treatment of Rheumatoid Arthritis

Reize, P.; Leichtle, Carmen; Leichtle, Ulf; Schanbacher, J.

doi:10.1177/107110070602700804

Cited by 26 publications

(5 citation statements)

References 18 publications

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“…Other studies have listed wound healing problems in the range of 4% to 24% and infection rates in the range of 0% to 14%. [8][9][10][11][12][13] If a deep infection occurs postoperatively and there is a suspicion of bone infection, hardware should be removed as soon as possible and a bone biopsy should be performed to definitively determine the presence of osteomyelitis. If bone infection is indeed present, the use of external fixation may prove beneficial to maintain bony alignment while antibiotic spacers and intravenous antibiotics are used to treat the infection.…”

Section: Wound Healing and Infectionmentioning

confidence: 99%

The Complications Encountered with the Rheumatoid Surgical Foot and Ankle

Reeves

Peaden

Shane

2010

Clinics in Podiatric Medicine and Surgery

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Section: Wound Healing and Infectionmentioning

confidence: 99%

The Complications Encountered with the Rheumatoid Surgical Foot and Ankle

Reeves

Peaden

Shane

2010

Clinics in Podiatric Medicine and Surgery

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“…First MTP joint arthrodesis [ 51 , 56 , 57 ] and second to fifth MTP joint arthroplasty [ 58 ], are the most documented surgeries [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis

Ramos-Petersen,

Reinoso-Cobo,

Ortega-Avila

et al. 2024

Rheumatol Int

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Rheumatoid arthritis causes progressive joint destruction in the long term, causing a deterioration of the foot and ankle. A clinical practice guideline has been created with the main objective of providing recommendations in the field of podiatry for the conservative management of rheumatoid arthritis. Thus, healthcare professionals involved in foot care of adults with rheumatoid arthritis will be able to follow practical recommendations. A clinical practice guideline was created including a group of experts (podiatrists, rheumatologists, nurses, an orthopaedic surgeon, a physiotherapist, an occupational therapist and patient with rheumatoid arthritis). Methodological experts using GRADE were tasked with systematically reviewing the available scientific evidence and developing the information which serves as a basis for the expert group to make recommendations. Key findings include the efficacy of chiropody in alleviating hyperkeratotic lesions and improving short-term pain and functionality. Notably, custom and standardized foot orthoses demonstrated significant benefits in reducing foot pain, enhancing physical function, and improving life quality. Therapeutic footwear was identified as crucial for pain reduction and mobility improvement, emphasizing the necessity for custom-made options tailored to individual patient needs. Surgical interventions were recommended for cases which were non-responsive to conservative treatments, aimed at preserving foot functionality and reducing pain. Moreover, self-care strategies and education were underscored as essential components for promoting patient independence and health maintenance. A series of recommendations have been created which will help professionals and patients to manage podiatric pathologies derived from rheumatoid arthritis.

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“…Although joint-preserving procedures have been regarded as standard treatment for chronic metatarsophalangeal dislocation of deformed lesser toes, resection arthroplasty of metatarsal head is a reasonable alternative approach for patients with rheumatoid arthritis. 21 Resection arthroplasty through plantar approach offered good results, including reducing pain and improving ambulation, in a 20-year long-term follow-up study in which more than 80% of patients felt satisfied with the outcome. 23 Despite good results reported with resection arthroplasty, some surgeons may still prefer to use modified metatarsal shortening offset osteotomy for joint preservation even in rheumatoid cases.…”

Section: Discussionmentioning

confidence: 97%

Distal Metatarsal Segmental Shortening for the Treatment of Chronic Metatarsophalangeal Dislocation of Lesser Toes

Tzeng²,

Wang

et al. 2020

Foot Ankle Int.

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Background: This retrospective study aimed to describe the techniques and results of distal metatarsal segmental shortening (DMSS) for the treatment of chronic irreducible metatarsophalangeal (MTP) dislocation of lesser toes. Methods: We retrospectively reviewed patients who underwent DMSS for chronic dislocation of MTP joints of lesser toes between January 2010 and December 2017 with follow-up of at least 24 months. Demographic data, radiographic measurements, functional outcomes, and complications were analyzed. Furthermore, the results of patients with short segment of shortening (group I, <10 mm) were compared to those with long segment of shortening (group II, ≥10 mm). A total of 43 MTP joints of 30 patients with an average age of 70.4 years were included. Results: Union was observed in 42 metatarsals (97.7%). Mean American Orthopaedic Foot & Ankle Society scale scores improved significantly from 42.2 (range, 15-65) preoperatively to 79.1 (range, 52-90) ( P < .001). Mean visual analog scale pain score improved significantly from 5.0 (range, 1-9) preoperatively to 1.8 (range, 0-6) ( P < .001). Complications included 1 nonunion, 1 osteonecrosis, 3 metatarsal angulation, 4 recurrent instability, 4 symptomatic osteoarthritis, 3 transfer metatarsalgia, and 1 floating toe. Group I included 23 MTP joints and group II included 20 MTP joints. There was no significant difference in clinical outcomes and complications between the 2 groups. Conclusion: DMSS was a reliable procedure for the treatment of chronic irreducible dislocated MTP joint of lesser toes. It provided satisfactory surgical outcomes and a low rate of postoperative complications, regardless of length of metatarsal shortening. Level of Evidence: Level III, retrospective comparative study.

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Long-Term Results after Metatarsal Head Resection in the Treatment of Rheumatoid Arthritis

Cited by 26 publications

References 18 publications

The Complications Encountered with the Rheumatoid Surgical Foot and Ankle

The Complications Encountered with the Rheumatoid Surgical Foot and Ankle

A clinical practice guideline for the management of the foot and ankle in rheumatoid arthritis

Distal Metatarsal Segmental Shortening for the Treatment of Chronic Metatarsophalangeal Dislocation of Lesser Toes

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