Nakamura M, Torisu T, Itonaga I, Masumi S
Department of Orthopaedic Surgery, Oita Medical University.
Ryumachi. 1993 Feb;33(1):44-9.
Results of forefoot surgery with rheumatoid arthritis were evaluated in 19 feet of 11 patients. Clayton's operation was performed on 12 feet of 7 patients. The follow-up averaged 3 years and 10 months (range, 2 years and 1 month to 8 years). 1 foot (8.3%) recurred hallux valgus deformity and 3 feet (25%) recurred hammer toe deformity. But all patients complained of difficulties to push off action on the forefoot. Interpositional arthroplasty of the first metatarsophalangeal joint with shortening-valgus osteotomy through the first metatarsal base was done on 7 feet of 4 patients. The follow-up averaged 1 years and 8 months (range, 8 months to 2 years and 2 months). 2 feet recurred hammer toe deformity. But, this group had no problem to push off action on the forefoot compared with Clayton's operation. As regard the relief of pain, all patients had satisfactory results from both methods. These results clarified that the preservation for the first metatarsophalangeal joint function was superior for push off action on the forefoot.
对11例患者的19只足进行了类风湿性关节炎前足手术的结果评估。7例患者的12只足接受了克莱顿手术。随访平均3年10个月（范围为2年1个月至8年）。1只足（8.3%）出现拇外翻畸形复发，3只足（25%）出现锤状趾畸形复发。但所有患者均抱怨前足蹬离动作困难。4例患者的7只足进行了第一跖趾关节间置关节成形术并通过第一跖骨基底进行短缩外翻截骨术。随访平均1年8个月（范围为8个月至2年2个月）。2只足出现锤状趾畸形复发。但是，与克莱顿手术相比，该组在前足蹬离动作方面没有问题。关于疼痛缓解，两种方法对所有患者均有满意的效果。这些结果表明，保留第一跖趾关节功能在前足蹬离动作方面更具优势。
