SURGICAL-CORRECTION OF RHEUMATOID FOREFOOT DEFORMITIES

Surgical correction of severe rheumatoid forefoot deformities with res ection arthroplasties of the lesser metatarsal phalangeal joints and a rthrodesis of the first metatarsal phalangeal joint resulted in a sign ificant long-term improvement with respect to shoe wear, pain, and the ability to stand and walk in 95% of the patients. Ninety percent had a good or excellent functional result. There was minimal recurrence of deformity. Modifications of the procedure with maintenance of the pro ximal phalangeal bases and K-wire fixation of the metatarsal phalangea l arthroplasty and interphalangeal joints resulted in an improved cosm etic result and simplified postoperative management with an equal func tional result and no increase in recurrence of deformity or complicati ons.