Abstract
BackgroundThis study aimed to clarify the characteristics associated with postoperative floating of the lesser toes, especially focusing on the medial and lateral lessor toes, after arthrodesis of the first metatarsophalangeal joint and resection arthroplasty of the lessor toes in rheumatoid forefoot deformity.MethodsFourty-seven feet of 43 people who underwent resection arthroplasty of the metatarsal head of the lesser toes for rheumatoid arthritis of the metatarsophalangeal joints were included. We retrospectively evaluated the preoperative radiographic findings and clinical characteristics of the patients, and the occurrence of postoperative floating of the lesser toes. The mean duration of follow-up was 36.5 (range 12 to 114) months.ResultsPreoperative dislocation grades of the second and third toes that demonstrated postoperative floating were significantly higher than those of toes that did not experience postoperative floating. The hallux valgus deformity before surgery was significantly more severe in toes with postoperative floating of the second and third lessor toes than those with no floating (p < 0.05). In addition, the Japanese Society for Surgery of the Foot (JSSF) hallux scale scores before surgery in toes with postoperative floating of the fourth and fifth lessor toes were significantly worse than those in non-dislocating toes (p < 0.05).ConclusionsThe preoperative condition of the first metatarsophalangeal joint, including hallux valgus deformity, pain, range of motion, activity of daily living, and function is significantly different between postoperative floating of the lesser toes and non-floating of them after resection arthroplasty for rheumatoid forefoot deformity.
Highlights
This study aimed to clarify the characteristics associated with postoperative floating of the lesser toes, especially focusing on the medial and lateral lessor toes, after arthrodesis of the first metatarsophalangeal joint and resection arthroplasty of the lessor toes in rheumatoid forefoot deformity
Previous studies have shown that uneven and insufficient bone resection and preoperative MTP joint dislocation are risk factors for postoperative floating of the lesser toes after resection arthroplasty of the metatarsal heads of the lesser toes [10, 11]
The aim of this study was to clarify the characteristics for postoperative floating of the lesser toes, especially focusing on the differences between the medial and lateral lessor toes, after resection arthroplasty for rheumatoid forefoot deformity
Summary
This study aimed to clarify the characteristics associated with postoperative floating of the lesser toes, especially focusing on the medial and lateral lessor toes, after arthrodesis of the first metatarsophalangeal joint and resection arthroplasty of the lessor toes in rheumatoid forefoot deformity. Joint-preserving procedures are commonly performed in patients with controllable RA, postoperative floating of the lesser toes, occurring as a complication following these surgeries, is reported to be a risk factor for unsatisfactory clinical outcomes [9]. Previous studies have shown that uneven and insufficient bone resection and preoperative MTP joint dislocation are risk factors for postoperative floating of the lesser toes after resection arthroplasty of the metatarsal heads of the lesser toes [10, 11]. The anatomic factors for postoperative floating of the lesser toes after resection arthroplasty of the metatarsal heads of the lesser toes are not fully understood
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
