Abstract
Objective: to reduce surgical approach and to ensure early weight bearing postoperatively. Material and method: by the example of 24 surgeries the results of the 1st MTCJ arthrodesis percutaneous modification, proposed by the author, were reviewed with the mean follow-up of 6 months. Surgical technique was described. 1st MTCJ hypermobility, severe metatarsus primus varus and previous surgeries failures were the indications for surgery. Immediate ambulation with one crutch and fool weight bearing since the 4-5th week postoperatively were authorized. Results: desired correction of the first metatarsal was achieved during 23 interventions. Arthrodesis had fused in 21 of 23 cases that were followed up. Two cases of non-union did not require reoperation. No infectious complications were noted.21 patients were discharged the next day after surgery due to painless early postoperative period. Conclusions: percutaneous 1st MTCJ arthrodesis is a safe and predictable procedure. Proposed surgical technique provides a reliable correction of metatarsus primus varus avoiding the main disadvantages of Lapidus procedure: extensive operative approach and postoperative period of fool non-weight bearing.
Highlights
Surgical technique was described. 1st MTCJ hypermobility, severe metatarsus primus varus and previous surgeries failures were the indications for surgery
No infectious complications were noted.21 patients were discharged the day after surgery due to painless early postoperative period
Proposed surgical technique provides a reliable correction of metatarsus primus varus avoiding the main disadvantages of Lapidus procedure: extensive operative approach and postoperative period of fool non-weight bearing
Summary
ЧРЕСКОЖНАЯ МОДИФИКАЦИЯ АРТРОДЕЗА ПЕРВОГО ПЛЮСНЕКЛИНОВИДНОГО СУСТАВА: ПРОСПЕКТИВНОЕ ИССЛЕДОВАНИЕ. Цель исследования: уменьшить травматичность операции артродеза I плюснеклиновидного сустава (ПКС) и добиться возможности ранней послеоперационной нагрузки. Проанализированы результаты операций на 24 стопах с применением предложенной автором чрескожной модификации артродеза I ПКС. Показаниями для вмешательства явились гипермобильность I ПКС, выраженное варусное отклонение 1 плюсневой кости, неудачные исходы предыдущих операций. Ходьба при помощи одного костыля с частичной нагрузкой на стопу разрешалась сразу после операции, полная нагрузка – с 4-5-й недели после вмешательства. Запланированная коррекция положения 1-й плюсневой кости достигнута в ходе 23 операций. Артродез состоялся в 21 из 23 прослеженных случаев. В 2 наблюдениях артродез не состоялся, однако повторное вмешательство не потребовалось. Чрескожный артродез I ПКС – безопасный и воспроизводимый способ коррекции metatarsus primus varus. Ключевые слова: артродез первого плюснеклиновидного сустава; чрескожная хирургия стопы, операция Лапидуса. PERCUTANEOUS MODIFICATION OF FIRST METATARSOCUNEIFORM JOINT ARTHRODESIS: A PROSPECTIVE STUDY
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