LONG-TERM FOLLOW-UP RESULTS AFTER RESECTION ARTHROPLASTY OF THE GREATTOE

Introduction: Resection arthroplasty of the first metatarsal-phalangea l joint is a wellknown operation for hallux valgus. The follow-up resu lts more than 17 years after arthroplasty are reported and discussed. Material and methods: Between 1971 and 1980, 335 arthroplasties were p erformed on 205 patients. The only indication for arthroplasty of the great toe was hallux valgus. The technique of arthroplasty was accordi ng to Keller-Brandes. 102 patients were reexamined clinically and radi ographically, after 17.6 years on average. Results: Questionnaire asse ssment revealed a significantly prolonged walking distance and 70% of the patients were painfree at the time of investigation, whereas 67% s uffered from severe pain before operation. Clinical evaluation showed diminished wheightbearing of the great toe during walking and a reduce d range of motion of the partial-resectcd first metatarsal-phalangeal joint. Radiographically the shortening of the phalangeal bone of 37% w as evident as expected. Hallux-valgus-angle was 23 degrees at the time of investigation and 34 degrees preoperatively in the mean. Discussio n: The high rate of hallux valgus relapse, especially due to a high in termetatarsal angle demonstrate unsatisfactory longterm results by the Keller-Brandes operation. We now recommend this operation for older p atients and a differentiated approach according to the clinical and ra diographical situation for younger patients.