Effect of metatarsophalangeal joint fusion combined with metatarsophalangeal arthroplasty in the treatment of rheumatoid forefoot deformity in elderly patients
SONG Tienan1, ZHAO Deyuan1, TONG Yongjian2, SONG Bo1, XU Gang1
1. Department of Trauma Orthopedics, The First People's Hospital of Lianyungang, Lianyungang 222002, China; 2. Jinzhou Medical University, Jinzhou 121012, China
Abstract：Objective To explore the short-term efficacy of metatarsophalangeal joint fusion combined with metatarsophalangeal arthroplasty for rheumatoid forefoot deformity in the elderly. Methods Ninety-two elderly patients with rheumatoid forefoot deformity admitted to our hospital from July 2019 to July 2022 were selected as the subjects of this study, and all of them were treated with metatarsophalangeal joint fusion. The patients were followed up for two months to observe the changes of the hallux valgus Angle (HVA) and the 1st to 2nd intermetatarsal Angle (IMA) before and after surgery. American Society for Foot and Ankle Surgery (AOFAS) score, plantar pressure, pain scale (VAS), Berg Balance Scale (BBS) score, Modified Barthel Index (MBI) score and quality of life score of patients were recorded before and after surgery. Results Compared with preoperative results, postoperative HVA and IMA were decreased, pain, function, toe line of force and total score of AOFAS were increased, pressure in all parts of plantar was decreased, VAS score was decreased, BBS score and MBI score were increased. The scores of all dimensions of quality of life were higher than those before operation . During the follow-up period, among the 92 patients, there was 1 case of bone nonunion of the first metatarsophalangeal joint after surgery, 3 cases of delayed incision healing, and no wound infection, toe necrosis, recurrence, or plantar callose formation. Conclusion Metatarsophalangeal joint fusion combined with metatarsophalangeal arthroplasty has a significant short-term effect in elderly patients with rheumatoid forefoot deformity, which can reduce HVA and IMA, improve pain, reduce plantar pressure, improve quality of life, and effectively improve the structure and dysfunction of elderly patients with rheumatoid forefoot deformity.
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2024, Vol. 21 
