Stockley I, Betts R P, Getty C J, Rowley D I, Duckworth T
Northern General Hospital, Sheffield, England.
Clin Orthop Relat Res. 1989 Nov(248):213-8.
The Kates et al. metatarsal head resection arthroplasty has been modified and evaluated clinically and objectively using a dynamic pedobarograph in 35 adult rheumatoid arthritis patients. Preoperatively, all patients complained of severe forefoot pain, but only 70% recorded abnormal plantar pressure measurements. After a mean follow-up time of 36 months, 91% of the patients were satisfied with the result following surgery. Forty-two feet were pain-free, 16 feet still painful but less than preoperatively, and two feet worse. Thirteen of the 18 painful feet recorded abnormal pressure, but 16 additional feet with normal pressures were symptomatic. The clinical and pedobarographic results show that, in the majority of patients, the Kates et al. forefoot arthroplasty relieves pain, improves mobility, effectively decreases high abnormal plantar pressures, and should be considered when conservative methods of treatment have failed.
凯特等人的跖骨头切除术已得到改良，并使用动态足底压力分析仪对35例成年类风湿性关节炎患者进行了临床和客观评估。术前，所有患者均主诉前足剧痛，但只有70%的患者足底压力测量结果异常。平均随访36个月后，91%的患者对手术结果满意。42只脚无痛，16只脚仍有疼痛但比术前减轻，2只脚情况恶化。18只疼痛的脚中有13只压力测量结果异常，但另有16只压力正常的脚也有症状。临床和足底压力分析结果表明，对于大多数患者来说，凯特等人的前足关节成形术可缓解疼痛、改善活动能力、有效降低异常的高足底压力，在保守治疗方法失败时应考虑采用该手术。
