CORRECTION OF DEFORMITY AT PATIENTS WITH RHEUMATOID FOOT ARTHRODESIS OF THE 1ST MP JOINT AND HEAD RESECTION OF THE II-V METATARSALS

Material-Methods: At 18 patients with Seronegative Chronic Polyarthritis(16 women, 2men, M.A 64,5 y) we made 24 Hoffmann-Tillmann procedures at the forefoot (6 right,6 left,6 both).At 2 patients we repeated the operation due to pseudarthrosis, at 2 patients we applied a corrective operation at the 2nd toe and at 1 patient we removed the osteosynthesis materials. The postoperative and Radiologic control of 15 patients(20 foots) was continued for 1,5–7,5 y(M.3,5y).We had phone contact with 2 patients and for 1 patient, who died, we used the latest evaluation. All the patients were satisfied with the postoperative results. Walking and shoe use were incompliant. At 2 patients we mentioned slight hyperextension of the 1st MP joint and at 2 patients asymptomatic pseuthasrthrosis of the 1st MP joint. The M.V. of the HV angle was 17° and the inclination angle between Metatarsals and toes was 20°.The Phalanges showed mild to major degree Osteoporosis. The Hallux AOFAS Score was 83 (49–90) and for the remain toes 89,5(79–97).The results according to Mielke Score were very good at 15 foots and good at 5 foots. Conclusions: Arthrodesis of the 1st MP joint in combination with head resection of the II-V Metatarsals is a very effective method for the treatment of the Rheumatoid foot.