Metatarsophalangeal arthrodesis of the hallux and arthroplastic resection of the second to fifth metatarsal heads in the rheumatic foot

• Published in: Acta ortopédica mexicana Vol. 27; no. 2; pp. 78 - 86
• Main Authors: Parra-Téllez, P, López-Gavito, E, Vázquez-Escamilla, J
• Format: Journal Article
• Language: Spanish
• Published: Mexico 01.03.2013
• Subjects: Adult; Aged; Arthrodesis - methods; Arthroplasty - methods; Female; Foot Deformities, Acquired - diagnostic imaging; Foot Deformities, Acquired - etiology; Foot Deformities, Acquired - psychology; Foot Deformities, Acquired - surgery; Hallux - diagnostic imaging; Hallux - surgery; Hallux Valgus - diagnostic imaging; Hallux Valgus - etiology; Hallux Valgus - surgery; Hallux Varus - diagnostic imaging; Hallux Varus - etiology; Hallux Varus - surgery; Humans; Male; Metatarsal Bones - diagnostic imaging; Metatarsal Bones - surgery; Middle Aged; Pain Measurement; Pain, Postoperative; Prospective Studies; Quality of Life; Radiography; Rheumatic Diseases - complications; Rheumatic Diseases - diagnostic imaging; Rheumatic Diseases - surgery; Severity of Illness Index; Treatment Outcome
• ISSN: 2306-4102

The objective of this study is to assess the clinical and radiologic results of patients with rheumatic forefoot who underwent metatarsophalangeal arthrodesis of the first ray and arthroplastic resection of the second to fifth metatarsal heads at the National Rehabilitation Institute. This is a prospective comparative study of the clinical and radiological status before and after the surgical procedure; it is a descriptive, observational single-group study. From April 2006 to December 2011, 31 surgical procedures were performed in 29 female and two male patients. The SPSS 17.0 software was used for the statistical analysis. Efficacy and quality of life indicators were compared using mean comparison tests (Student t test), the indicator of patient safety by means of frequency analysis, and the comparative analysis of the occurrence of complications throughout time. The mean preoperative visual analog scale score was 6.2 +/- 1.3, with an average of 1.6 +/- 2.5, with statistical significance, with p < 0.0001 and t = 7.97. Radiographic measurements of the hallux valgus angle showed a remarkable improvement. The surgical procedure described is reliable and efficacious, as patients had an important improvement in quality of life, with pain relief and adaptation to their activities of daily living after surgery.