关节面破坏与外侧柱跖趾关节脱位引起的类风湿性前足畸形的相关性更高。

Higher association of articular surface destruction with rheumatoid forefoot deformity arising from dislocation of the metatarsophalangeal joints in the lateral column.

作者信息

Suzuki Yuki, Onodera Tomohiro, Iwasaki Koji, Matsuoka Masatake, Hamasaki Masanari, Kondo Eiji, Iwasaki Norimasa

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15 jo, Nishi 7 chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.

Department of Functional Reconstruction for the Knee Joint, Graduate School of Medicine, Hokkaido University, Kita 15 jo, Nishi 7 chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.

出版信息

J Orthop Sci. 2025 May;30(3):542-547. doi: 10.1016/j.jos.2024.07.010. Epub 2024 Aug 14.

DOI:10.1016/j.jos.2024.07.010

PMID:39147648

Abstract

BACKGROUND

To evaluate the relationship between the pattern and severity of metatarsophalangeal (MTP) joint dislocation in the lesser toes and severity of joint destruction in rheumatoid forefoot deformities.

METHODS

Participants comprised of 13 patients (16 feet) who underwent resection arthroplasty of the metatarsal head of the lesser toes for rheumatoid arthritis of the MTP joints. Correlations between preoperative radiographic findings and histological grades second to fifth metatarsal heads taken intraoperatively were analyzed.

RESULTS

In 62 metatarsal heads, complete dislocation of the MTP joint in the lesser toes significantly resulted in severe joint destruction compared to mild or moderate dislocation (P < 0.05). The proportion of severe cartilage damage in MTP joints with complete dislocation was 100 % in the 5th MTP joint, 83.3 % in the 4th MTP joint, and 58.3 % in the 2nd and 3rd MTP joints. Moreover, complete dislocation of the MTP joints in the lateral column showed the most severe joint destruction compared to that in the medial column (P = 0.03).

CONCLUSION

Complete dislocation of the MTP joint in the lateral column is related to joint destruction in rheumatoid forefoot deformities.

摘要

背景

评估小趾跖趾关节（MTP）脱位的类型和严重程度与类风湿性前足畸形中关节破坏严重程度之间的关系。

方法

研究对象包括13例患者（16足），这些患者因MTP关节类风湿性关节炎接受了小趾跖骨头切除术。分析术前影像学检查结果与术中获取的第二至第五跖骨头组织学分级之间的相关性。

结果

在62个跖骨头中，与轻度或中度脱位相比，小趾MTP关节完全脱位显著导致更严重的关节破坏（P < 0.05）。第五跖趾关节完全脱位的MTP关节中严重软骨损伤的比例在第5跖趾关节为100%，在第4跖趾关节为83.3%，在第2和第3跖趾关节为58.3%。此外，与内侧柱相比，外侧柱MTP关节完全脱位显示出最严重的关节破坏（P = 0.03）。