Gainor B J, Epstein R G, Henstorf J E, Olson S
Department of Surgery, School of Medicine, University of Missouri at Columbia.
Clin Orthop Relat Res. 1988 May(230):207-13.
Thirty-five feet in 21 patients, who had had metatarsal head resection for painful rheumatoid forefoot deformities, were analyzed retrospectively. All patients but one were allowed to ambulate 48 hours after surgery. The follow-up period averaged 29 months. A grading system was devised to assess the clinical results based upon pain relief, capacity to ambulate, shoe wear, cosmesis, and use of walking aids. Using this system, the results were 46% excellent, 34% good, 17% fair, and 3% poor. One patient developed a superficial wound infection, which healed uneventfully. Bony impingement was observed on follow-up roentgenograms of 67% of the resectional arthroplasties. This finding was generally asymptomatic, and it did not correlate with the clinical outcome. Smooth wire fixation was used in some of the feet, but it did not improve the results either roentgenographically or clinically.
对21例行跖骨头切除术以治疗疼痛性类风湿性前足畸形的患者共35只足进行了回顾性分析。除1例患者外，所有患者均在术后48小时允许行走。随访期平均为29个月。设计了一种分级系统，根据疼痛缓解情况、行走能力、鞋类穿着、美观程度及助行器使用情况来评估临床结果。采用该系统，结果为优46%、良34%、中17%、差3%。1例患者发生表浅伤口感染，经治疗顺利愈合。在67%的切除成形术随访X线片上观察到骨撞击。这一发现通常无症状，且与临床结果无关。部分足部使用了光滑钢丝固定，但在X线或临床方面均未改善结果。
