Abstract
Objectives: The introduction of powerful antirheumatic drugs has dramatically improved the treatment of rheumatoid arthritis (RA), leading clinicians to reconsider the benefits of joint preservation for rheumatoid forefoot deformities. We have employed joint-preserving forefoot surgeries, including rotational closing-wedge osteotomy of the first metatarsal. The aim of our study is to assess the short-term results of this procedure. Methods: From January 2011 through December 2011, 35 feet were treated with this procedure. Subjective, functional, and radiographic outcomes were surveyed. Results: The mean Japanese Society for Surgery of the Foot improved from a preoperative level of 52.6 to 68.7 postoperatively. The average hallux valgus and intermetatarsal angles improved from 47.3 preoperatively to 17.5 postoperatively, and from 16.7 preoperatively to 9.0 postoperatively, respectively. To assess the repositioning of pronation deformities of the first metatarsal, the position of the medial sesamoid was also surveyed according to the measurement system proposed by Hardy and Clapham. All feet except two were classified as grade V or higher preoperatively; 25 of these were grade IV or lower at the latest follow-up. Conclusions: Rotational closing-wedge osteotomy of the first metatarsal was beneficial for correcting forefoot deformities in RA over the short term.
| Original language | English |
|---|---|
| Pages (from-to) | 953-958 |
| Number of pages | 6 |
| Journal | Modern Rheumatology |
| Volume | 23 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2013 Sep |
| Externally published | Yes |
Fingerprint
Keywords
- Hallux valgus
- Joint-preserving surgery
- Osteotomy of first metatarsal
- Rheumatoid arthritis
- Rotational closing-wedge osteotomy
ASJC Scopus subject areas
- Rheumatology
Cite this
Proximal rotational closing-wedge osteotomy of the first metatarsal in rheumatoid arthritis : Clinical and radiographic evaluation of a continuous series of 35 cases. / Yano, Koichiro; Ikari, Katsunori; Iwamoto, Takuji; Saito, Asami; Naito, Yurino; Kawakami, Kosei; Suzuki, Taku; Imamura, Hitoshi; Sakuma, Yu; Hiroshima, Ryo; Momohara, Shigeki.
In: Modern Rheumatology, Vol. 23, No. 5, 09.2013, p. 953-958.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Proximal rotational closing-wedge osteotomy of the first metatarsal in rheumatoid arthritis
T2 - Clinical and radiographic evaluation of a continuous series of 35 cases
AU - Yano, Koichiro
AU - Ikari, Katsunori
AU - Iwamoto, Takuji
AU - Saito, Asami
AU - Naito, Yurino
AU - Kawakami, Kosei
AU - Suzuki, Taku
AU - Imamura, Hitoshi
AU - Sakuma, Yu
AU - Hiroshima, Ryo
AU - Momohara, Shigeki
PY - 2013/9
Y1 - 2013/9
N2 - Objectives: The introduction of powerful antirheumatic drugs has dramatically improved the treatment of rheumatoid arthritis (RA), leading clinicians to reconsider the benefits of joint preservation for rheumatoid forefoot deformities. We have employed joint-preserving forefoot surgeries, including rotational closing-wedge osteotomy of the first metatarsal. The aim of our study is to assess the short-term results of this procedure. Methods: From January 2011 through December 2011, 35 feet were treated with this procedure. Subjective, functional, and radiographic outcomes were surveyed. Results: The mean Japanese Society for Surgery of the Foot improved from a preoperative level of 52.6 to 68.7 postoperatively. The average hallux valgus and intermetatarsal angles improved from 47.3 preoperatively to 17.5 postoperatively, and from 16.7 preoperatively to 9.0 postoperatively, respectively. To assess the repositioning of pronation deformities of the first metatarsal, the position of the medial sesamoid was also surveyed according to the measurement system proposed by Hardy and Clapham. All feet except two were classified as grade V or higher preoperatively; 25 of these were grade IV or lower at the latest follow-up. Conclusions: Rotational closing-wedge osteotomy of the first metatarsal was beneficial for correcting forefoot deformities in RA over the short term.
AB - Objectives: The introduction of powerful antirheumatic drugs has dramatically improved the treatment of rheumatoid arthritis (RA), leading clinicians to reconsider the benefits of joint preservation for rheumatoid forefoot deformities. We have employed joint-preserving forefoot surgeries, including rotational closing-wedge osteotomy of the first metatarsal. The aim of our study is to assess the short-term results of this procedure. Methods: From January 2011 through December 2011, 35 feet were treated with this procedure. Subjective, functional, and radiographic outcomes were surveyed. Results: The mean Japanese Society for Surgery of the Foot improved from a preoperative level of 52.6 to 68.7 postoperatively. The average hallux valgus and intermetatarsal angles improved from 47.3 preoperatively to 17.5 postoperatively, and from 16.7 preoperatively to 9.0 postoperatively, respectively. To assess the repositioning of pronation deformities of the first metatarsal, the position of the medial sesamoid was also surveyed according to the measurement system proposed by Hardy and Clapham. All feet except two were classified as grade V or higher preoperatively; 25 of these were grade IV or lower at the latest follow-up. Conclusions: Rotational closing-wedge osteotomy of the first metatarsal was beneficial for correcting forefoot deformities in RA over the short term.
KW - Hallux valgus
KW - Joint-preserving surgery
KW - Osteotomy of first metatarsal
KW - Rheumatoid arthritis
KW - Rotational closing-wedge osteotomy
UR - http://www.scopus.com/inward/record.url?scp=84885191146&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885191146&partnerID=8YFLogxK
U2 - 10.1007/s10165-012-0776-9
DO - 10.1007/s10165-012-0776-9
M3 - Article
C2 - 23070360
AN - SCOPUS:84885191146
VL - 23
SP - 953
EP - 958
JO - Modern Rheumatology
JF - Modern Rheumatology
SN - 1439-7595
IS - 5
ER -