Mann R A, Thompson F M
J Bone Joint Surg Am. 1984 Jun;66(5):687-92.
We reviewed the results of reconstruction of the fore part of the foot in rheumatoid patients by arthrodesis of the first metatarsophalangeal joint. The follow-up averaged 4.1 years (range, 2.0 to 7.25 years). Eighteen feet in eleven women were operated on. Twelve feet underwent total reconstruction of the fore part: arthrodesis of the first metatarsophalangeal joint and excision of all of the lesser metatarsophalangeal joints. Six feet underwent subtotal reconstruction, which included arthrodesis of the first metatarsophalangeal joint. The results were classified as excellent in fourteen feet, good in two, and fair in two. There were no poor results. Metatarsophalangeal bone fusion was achieved in all but one foot (fusion rate, 94 per cent). The one fibrous ankylosis was painless, with satisfactory function. Interphalangeal degenerative joint disease was a radiographic but not a clinical sequela. Arthrodesis of the first metatarsophalangeal joint provided stability that permanently corrected deformity, permitted the patients to wear ordinary shoes, and, in combination with excisional arthroplasty of involved lesser metatarsophalangeal joints, relieved disabling pain in the fore part of the foot.
我们回顾了通过第一跖趾关节融合术对类风湿性关节炎患者足部前段进行重建的结果。随访时间平均为4.1年（范围为2.0至7.25年）。对11名女性的18只脚进行了手术。12只脚接受了足部前段的全重建：第一跖趾关节融合术以及所有小跖趾关节切除术。6只脚接受了次全重建，其中包括第一跖趾关节融合术。结果分类为：14只脚为优，2只为良，2只为可。没有差的结果。除1只脚外，所有跖趾关节均实现了骨融合（融合率为94%）。这例纤维性关节强硬无痛，功能令人满意。指间关节退变是影像学表现而非临床后遗症。第一跖趾关节融合术提供了稳定性，永久性矫正了畸形，使患者能够穿普通鞋子，并且与受累小跖趾关节的切除性关节成形术相结合，缓解了足部前段的致残性疼痛。
