Seung-Hwan Park, Young Rak Choi, Jaehyung Lee, Chang Hyun Doh, Ho Seong Lee
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Radiological evaluations were conducted, assessing the hallux valgus angle, the intermetatarsal angle between the first and second metatarsals, and the Sharp/van der Heijde score for erosion and joint space narrowing. Clinical outcomes were quantified using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society forefoot scores to measure function and alignment.</p><p><strong>Results: </strong>The mean hallux valgus angle decreased from 38.0° (range, 25°-65°) preoperatively to 3.5° (range, 0°-17°) at the final follow-up (<i>p</i> < 0.05). The mean intermetatarsal angle decreased from 14.9° (range, 5°-22°) preoperatively to 4.3° (range, 2°-11°) at the final follow-up. (<i>p</i> < 0.05). Regarding the Sharp/van der Heijde score, the mean erosion score (0-10) showed no significant change, decreasing from 3.83 (range, 0-6) preoperatively to 3.54 (range, 0-4) at the final follow-up (<i>p</i> = 0.12). Recurrent hallux valgus was observed in 1 patient and postoperative hallux varus deformity was observed in 2 feet. Spontaneous fusion of the metatarsophalangeal joint developed in 1 case.</p><p><strong>Conclusions: </strong>DCMO resulted in satisfactory clinical and radiographic outcomes for correcting RA-associated hallux valgus deformity.</p>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130625/pdf/","citationCount":"0","resultStr":"{\"title\":\"Joint-Preserving Surgery for Hallux Valgus Deformity in Rheumatoid Arthritis.\",\"authors\":\"Seung-Hwan Park, Young Rak Choi, Jaehyung Lee, Chang Hyun Doh, Ho Seong Lee\",\"doi\":\"10.4055/cios23184\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disorder that frequently causes forefoot deformities. Arthrodesis of the first metatarsophalangeal joint is a common surgery for severe hallux valgus. However, joint-preserving surgery can maintain the mobility of the joint. This study aimed to investigate the clinical and radiographic outcomes of distal chevron metatarsal osteotomy (DCMO) for correcting hallux valgus deformity associated with RA.</p><p><strong>Methods: </strong>Between August 2000 and December 2018, 18 consecutive patients with rheumatoid forefoot deformities (24 feet) underwent DCMO for hallux valgus with/without lesser toe surgery. Radiological evaluations were conducted, assessing the hallux valgus angle, the intermetatarsal angle between the first and second metatarsals, and the Sharp/van der Heijde score for erosion and joint space narrowing. Clinical outcomes were quantified using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society forefoot scores to measure function and alignment.</p><p><strong>Results: </strong>The mean hallux valgus angle decreased from 38.0° (range, 25°-65°) preoperatively to 3.5° (range, 0°-17°) at the final follow-up (<i>p</i> < 0.05). The mean intermetatarsal angle decreased from 14.9° (range, 5°-22°) preoperatively to 4.3° (range, 2°-11°) at the final follow-up. (<i>p</i> < 0.05). Regarding the Sharp/van der Heijde score, the mean erosion score (0-10) showed no significant change, decreasing from 3.83 (range, 0-6) preoperatively to 3.54 (range, 0-4) at the final follow-up (<i>p</i> = 0.12). Recurrent hallux valgus was observed in 1 patient and postoperative hallux varus deformity was observed in 2 feet. 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引用次数: 0
摘要
背景：类风湿性关节炎（RA）是一种慢性自身免疫性疾病，经常导致前足畸形。第一跖趾关节的关节固定术是治疗严重足外翻的常见手术。然而，保留关节的手术可以保持关节的活动度。本研究旨在探讨远端螯跖骨截骨术（DCMO）矫正与RA相关的拇指外翻畸形的临床和影像学效果：2000年8月至2018年12月期间，连续18例类风湿前足畸形患者（24足）接受了DCMO治疗拇指外翻，同时接受/不接受小趾手术。进行了放射学评估，评估了拇指外翻角度、第一跖骨和第二跖骨之间的跖间角度，以及Sharp/van der Heijde侵蚀和关节间隙狭窄评分。临床结果采用视觉模拟量表来量化疼痛程度，并采用美国骨科足踝协会前足评分来衡量功能和对齐情况：结果：平均拇指外翻角度从术前的38.0°（范围：25°-65°）下降到最终随访时的3.5°（范围：0°-17°）（p < 0.05）。平均跖间角从术前的 14.9°（范围：5°-22°）下降到最终随访时的 4.3°（范围：2°-11°）。(p < 0.05).至于 Sharp/van der Heijde 评分，平均侵蚀评分（0-10）没有明显变化，从术前的 3.83（范围 0-6）降至最终随访时的 3.54（范围 0-4）（p = 0.12）。1例患者出现复发性拇指外翻，2例患者术后出现拇指外翻畸形。1例患者的跖趾关节发生自发性融合：结论：DCMO 在矫正与 RA 相关的足外翻畸形方面取得了令人满意的临床和影像学效果。
Joint-Preserving Surgery for Hallux Valgus Deformity in Rheumatoid Arthritis.
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder that frequently causes forefoot deformities. Arthrodesis of the first metatarsophalangeal joint is a common surgery for severe hallux valgus. However, joint-preserving surgery can maintain the mobility of the joint. This study aimed to investigate the clinical and radiographic outcomes of distal chevron metatarsal osteotomy (DCMO) for correcting hallux valgus deformity associated with RA.
Methods: Between August 2000 and December 2018, 18 consecutive patients with rheumatoid forefoot deformities (24 feet) underwent DCMO for hallux valgus with/without lesser toe surgery. Radiological evaluations were conducted, assessing the hallux valgus angle, the intermetatarsal angle between the first and second metatarsals, and the Sharp/van der Heijde score for erosion and joint space narrowing. Clinical outcomes were quantified using a visual analog scale for pain and the American Orthopaedic Foot and Ankle Society forefoot scores to measure function and alignment.
Results: The mean hallux valgus angle decreased from 38.0° (range, 25°-65°) preoperatively to 3.5° (range, 0°-17°) at the final follow-up (p < 0.05). The mean intermetatarsal angle decreased from 14.9° (range, 5°-22°) preoperatively to 4.3° (range, 2°-11°) at the final follow-up. (p < 0.05). Regarding the Sharp/van der Heijde score, the mean erosion score (0-10) showed no significant change, decreasing from 3.83 (range, 0-6) preoperatively to 3.54 (range, 0-4) at the final follow-up (p = 0.12). Recurrent hallux valgus was observed in 1 patient and postoperative hallux varus deformity was observed in 2 feet. Spontaneous fusion of the metatarsophalangeal joint developed in 1 case.
Conclusions: DCMO resulted in satisfactory clinical and radiographic outcomes for correcting RA-associated hallux valgus deformity.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
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