Objective. To compare the efficacy of surgical treatment of rheumatoid forefoot using traditional methods or the developed method.
Materials and methods. The results of surgical treatment of the forefoot deformities have been studied in 70 patients (63 women and 7 men) with rheumatoid arthritis (RA). In 36 patients the operation was performed on both feet, 106 feet were operated on. The patients were divided into 4 groups. In groups 1, 2, 3 traditional methods of surgical treatment of rheumatoid forefoot were used. In group 4 the developed method of the resection of the 2nd, the 3rd, the 4th, and
the 5th metatarsal heads was used. The American Orthopedic Foot and Ankle Society Hallux Valgus Scale (AOFAS—I) and Lesser Toe Scale (AOFAS—II—V) were used for the clinical evaluation of the feet. The level of pain syndrome was determined using a visual analogue scale (VAS). The Hallux Valgus Angle (HVA) and 1—2—Intermetatarsal Angle (1—2—IMA) were measured for radiographic evaluation. The condition of the feet was assessed before surgery, at 6 and
24 months after surgery.
Results. Comparison of groups 24 months surgery showed that the use of arthroplasty of the 1st metatarsophalangeal joint (MPJ) according to the Keller—Brandes method does not provide stable correction of the deformity of the hallux, especially when osteotomy of the 1st metatarsal is not performed. Unlike arthroplasty, the use of arthrodesis makes it possible to obtain a stable correction of the 1st MPJ for a long period of time and provides the best clinical results according to the AOFAS—I scale.
Сonclusion The use of the developed method of resection arthroplasty using the proposed device leads to a maximum reduction in pain and provides the best clinical and functional outcome according to the AOFAS—II—V scale in comparison with traditional methods of treatment.
Автор(ы): S. S. Aliakseichyk