Surgical Treatment of Severe Hallux Abductovalgus With Dislocation of the First Metatarsophalangeal Joint: A Case Presentation and Surgical Technique

2019 ◽  
Vol 12 (3) ◽  
pp. 281-285 ◽  
Author(s):  
Kevin Tootle ◽  
JennaLou Hollnagel ◽  
Kyle Kinmon
Keyword(s):  
Rheumatoid Arthritis ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Metatarsophalangeal Joint ◽  
First Metatarsophalangeal Joint ◽  
Case Presentation ◽  
Levels Of Evidence ◽  
Evidence Level

Severe hallux abductovalgus deformity with dislocation and contracture at the first metatarsophalangeal joint is difficult to manage, especially in the presence of concomitant, long-standing rheumatoid arthritis. This article highlights a novel surgical technique that may be used to successfully address this challenging condition while minimizing the likelihood of complications. Levels of Evidence: Level IV

scholarly journals Deforming Arthrosis of First Metetarsophalangeal Joint (etiology, pathogenesis, peculiarities of surgical treatment)

2011 ◽  
Vol 18 (3) ◽  
pp. 63-69
Author(s):  
Aleksey Vital'evich Mazalov ◽  
N V Zagorodniy ◽  
V G Protsko ◽  
E M Sultanov ◽  
Z Kh Khamokov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Metatarsophalangeal Joint ◽  
First Metatarsophalangeal Joint ◽  
Articular Surfaces ◽  
Frequency Of Use ◽  
Fast Progression

Algorithm for the choice of surgical techniques for the treatment of first metetarsophalangeal joint arthrosis is presented. New aspects of etiopathogenesis are determined. It is shown that syndrome of progressing flat valgus foot causes overloading of dorsal articular surfaces of first metatarsophalangeal joint resulting in fast progression of arthrosis in this joint. Schemes of various types of operations, their correlation by frequency of use and efficacy depending on the degree of pathology severity are presented.

Forefoot Surgery in Rheumatoid Arthritis: Subjective Assessment of Outcome

Foot & Ankle ◽  
1987 ◽  
Vol 8 (3) ◽  
pp. 148-151 ◽  
Author(s):  
Lael G. Hasselo ◽  
Robert F. Willkens ◽  
Hugh E. Toomey ◽  
David E. Karges ◽  
Sigvard T. Hansen
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Severity ◽  
Metatarsophalangeal Joint ◽  
Severity Index ◽  
Subjective Assessment ◽  
Subjective Data ◽  
First Metatarsophalangeal Joint ◽  
Forefoot Surgery ◽  
First Ray ◽  
Better Than

Forefoot surgical outcomes were evaluated in 26 patients with rheumatoid arthritis. A total of 45 procedures were reviewed with emphasis on first ray intervention. Disease duration and aggressiveness of preceding medical therapy were combined to establish a disease severity index. Patients operated were predominantly in the midrange of disease severity. Subjective data on the relief of pain, callus, and deformity were favorable but this benefit was not long lasting inasmuch as patients were most satisfied in the period immediately following surgery and less so as time elapsed from intervention. Fusion of the first metatarsophalangeal joint seemed better than resection alone, indicating that stability should be the primary goal for surgical intervention of the rheumatoid forefoot.

Evaluation of Metatarsal Head Resurfacing Hemiarthroplasty in the Surgical Treatment of Hallux Rigidus: A Retrospective Study and Mid- to Long-Term Follow-up

2017 ◽  
Vol 11 (1) ◽  
pp. 22-31 ◽  
Author(s):  
Musa Uğur Mermerkaya ◽  
Erkan Alkan ◽  
Mehmet Ayvaz
Keyword(s):  
Surgical Treatment ◽  
Case Series ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Treatment Method ◽  
Hallux Rigidus ◽  
Retrospective Case ◽  
First Metatarsophalangeal Joint

Background. The aim of this study was to evaluate the mid- to long-term outcomes of metatarsal head resurfacing hemiarthroplasty in the surgical treatment of advanced-stage hallux rigidus. Methods. We performed a retrospective review of 57 consecutive patients (25 [43.9%] males, 32 [56.1%] females; mean age, 61.0 ± 6.4 years) who underwent first metatarsal head resurfacing hemiarthroplasty (HemiCAP) for hallux rigidus between August 2007 and September 2010. Sixty-five implantations were performed in 57 patients; 8 patients underwent bilateral procedures. All patients were clinically rated prior to surgery and at the final follow-up visit using the American Orthopaedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal-interphalangeal scale and first metatarsophalangeal joint range of motion (MTPJ ROM). Results. The median follow-up duration was 81 (range = 8-98) months. The median preoperative AOFAS score was 34 (range = 22-59) points, which had increased to 83 (range = 26-97) points at the final follow-up visit (P < .001). The median preoperative first MTPJ ROM was 25° (range = 15° to 40°), which had increased to 75° (range = 30° to 85°) at the final follow-up visit (P < .001). Conclusions. First MTPJ hemiarthroplasty is an effective treatment method that recovers toe function and first MTPJ ROM, and provides good mid- to long-term functional outcomes. Levels of Evidence: Level IV: Retrospective case series

Flexible hinge toe implant arthroplasty for rheumatoid arthritis of the first metatarsophalangeal joint: long-term results

2001 ◽  
Vol 6 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Tadamasa Hanyu ◽  
Hideshi Yamazaki ◽  
Hajime Ishikawa ◽  
Katsumitsu Arai ◽  
Chikako T. Tohyama ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Metatarsophalangeal Joint ◽  
Long Term Results ◽  
First Metatarsophalangeal Joint ◽  
Flexible Hinge

scholarly journals Cervical Myelopathy in Rheumatoid Arthritis

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
N. Mukerji ◽  
N. V. Todd
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Neck Pain ◽  
Surgical Management ◽  
Cervical Myelopathy ◽  
Clinical Presentation ◽  
Indications For Surgery ◽  
Grading Systems

Involvement of the cervical spine is common in rheumatoid arthritis. Clinical presentation can be variable, and symptoms may be due to neck pain or compressive myeloradiculopathy. We discuss the pathology, grading systems, clinical presentation, indications for surgery and surgical management of cervical myelopathy related to rheumatoid arthritis in this paper. We describe our surgical technique and results. We recommend early consultation for surgical management when involvement of the cervical spine is suspected in rheumatoid arthritis. Even patients with advanced cervical myelopathy should be discussed for surgical treatment, since in our experience improvement in function after surgery is common.

Technique Tip: Single-Incision Endoscopic Plantar Fasciotomy

2016 ◽  
Vol 10 (3) ◽  
pp. 240-241
Author(s):  
Zachary M. Thomas ◽  
Kristin J. Thomas
Keyword(s):  
Surgical Technique ◽  
Expert Opinion ◽  
Plantar Fasciitis ◽  
Single Incision ◽  
Smooth Transition ◽  
New Technique ◽  
Foot And Ankle ◽  
Levels Of Evidence ◽  
Evidence Level ◽  
Plantar Fasciotomy

Two-incision endoscopic plantar fasciotomy (EPF) is an accepted surgical technique in the treatment of recalcitrant plantar fasciitis. Single-incision plantar fasciotomy is a relatively new technique in the surgeons’ armamentarium; however, it is not without pitfalls, specifically poor visualization. This article aims to help the foot and ankle surgeon make a smooth transition from 2-incision EPF to single-incision EPF while maintaining optimum visualization. Levels of Evidence: Level V: Expert opinion

scholarly journals PRINCIPLES OF SURGICAL TREATMENT IN PATIENTS WITH OSTEOARTHRITIS OF THE FIRST METATARSOPHALANGEAL JOINT

2018 ◽  
Vol 56 (3) ◽  
pp. 363-372
Author(s):  
M. R. Nurmukhametov
Keyword(s):  
Surgical Treatment ◽  
Surgical Procedures ◽  
Gold Standard ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Cartilage Defects ◽  
First Metatarsophalangeal Joint ◽  
Younger Patients ◽  
Surgical Tactics ◽  
Joint Motions

At present, there is no general approach to choosing surgical tactics for hallux rigidus. Many surgical procedures are used to treat osteoarthritis (OA) of the first metatarsophalangeal joint (FMPJ), which are relevant at different stages of the disease. Nevertheless, this fact also suggests that all proposed methods have one or other disadvantages. At the same time, FMPJ arthrodesis that relieves pain and is functionally inferior to joint-sparing surgery remains the gold standard. However, due to the fact that not only persons over the age of 50 years, but also younger patients often suffer from FMPJ OA, the most non-damaging option of joint-sparing surgery is cheilectomy with chondroplasty of the FMPJ, which allows restoration of painless joint motions, thus sparing the anatomy of the foot. Chondroplasty using the authologous matrix-induced chondrogenesis (AMIC®) technique for knee, hip, and ankle cartilage defects is described. There are no reports on FMPJ chondroplasty with the AMIC method in either Russian or foreign literature.

scholarly journals The Combination of Modified Mitchell’s Osteotomy and Shortening Oblique Osteotomy for Patients with Rheumatoid Arthritis: An Analysis of Changes in Plantar Pressure Distribution

2021 ◽  
Vol 18 (19) ◽  
pp. 9948
Author(s):  
Hyunho Lee ◽  
Hajime Ishikawa ◽  
Tatsuaki Shibuya ◽  
Chinatsu Takai ◽  
Tetsuya Nemoto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pressure Distribution ◽  
Plantar Pressure ◽  
Peak Pressure ◽  
Metatarsophalangeal Joint ◽  
First Metatarsophalangeal Joint ◽  
Joint Deformity ◽  
Oblique Osteotomy ◽  
Plantar Pressure Distribution ◽  
Joint Preserving Surgery

The present study aims to evaluate changes in plantar pressure distribution after joint-preserving surgery for rheumatoid forefoot deformity. A retrospective study was performed on 26 feet of 23 patients with rheumatoid arthritis (RA) who underwent the following surgical combination: modified Mitchell’s osteotomy (mMO) of the first metatarsal and shortening oblique osteotomy of the lateral four metatarsals. Plantar pressure distribution and clinical background parameters were evaluated preoperatively and one year postoperatively. A comparison of preoperative and postoperative values indicated a significant improvement in the visual analog scale, Japanese Society for Surgery of the Foot scale, and radiographic parameters, such as the hallux valgus angle. A significant increase in peak pressure was observed at the first metatarsophalangeal joint (MTPJ) (0.045 vs. 0.082 kg/cm2; p < 0.05) and a significant decrease at the second and third MTPJs (0.081 vs. 0.048 kg/cm2; p < 0.05, 0.097 vs. 0.054 kg/cm2; p < 0.05). While overloading at the lateral metatarsal heads following mMO has been reported in previous studies, no increase in peak pressure at the lateral MTPJs was observed in our study. The results of our study show that this surgical combination can be an effective and beneficial surgical combination for RA patients with mild to moderate joint deformity.

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