Article ID Journal Published Year Pages File Type
2717314 The Journal of Foot and Ankle Surgery 2006 6 Pages PDF
Abstract

Twenty-nine patients (45 feet) who underwent metatarsal head resections for rheumatoid forefoot deformities were reviewed retrospectively at a mean follow-up of 6.57 years (range, 5-9.3 years). Resections were confined to the lesser metatarsal heads in 16 feet because of a lack of involvement in the first metatarsal head. In the remaining 29 feet, all metatarsal heads were resected. A questionnaire was provided to assess subjective outcomes. Thirty-three feet (73.3%) had no pain or only mild pain, 5 feet (11%) had moderate pain, and 7 (15.5%) had severe pain. Among the 29 feet with panmetatarsal head resections, 5 (17%) required revision of metatarsal stumps at an average follow-up of 55.2 months (range, 17-84 months; standard deviation, 26.88). Among the 16 feet with only lesser metatarsal head resections, 7 (43.75%) required subsequent first metatarsal head resections at an average follow-up period of 33.14 months (range, 13-56 months; standard deviation, 16.54). In conclusion, metatarsal head resection is a simple procedure that gives long-term pain relief in over two thirds of the patients who have rheumatoid forefoot deformities. A high rate of recurrence of pain and subsequent resection of first metatarsal head is noted if it is not resected primarily. We recommend a low threshold for the inclusion of some form of primary reconstruction of the first metatarsophalangeal joint when resection arthroplasty is performed on the lesser toes.

Related Topics
Health Sciences Medicine and Dentistry Orthopedics, Sports Medicine and Rehabilitation
Authors
, ,