目的 观察手术治疗类风湿足前足畸形的疗效.方法 自2005年1月至2008年12月对7例(12足)类风湿关节炎前足畸形的患者进行矫形手术,根据畸形的严重程度选择不同的手术方法治疗,术后进行临床和影像学评价.结果 本组7例12足手术全部成功,无手术并发症.经过平均45个月随访,术后临床效果满意,影像学改善明显.结论 对类风湿关节炎前足畸形患者通过不同的手术方式进行矫形可以获得满意的临床效果.%Objective To observe the result of operation for rheumatoid arthritis forefoot deformity. Methods Patients were treated with different type of technique include resection of the lesser-toe metatarsal heads coupled with arthrodesis of the great toe, resection arthroplasty of the proximal phalanx or metatarsal head, and metatarsal osteotomy. All patients were asked to return for follow-up, which included subjective assessment [ with use of AOFAS ( American Orthopaedic Foot and Ankle Society) forefoot scores ], physical examination, and radiographic evaluation. Results All results were satisfactory to excellent in the short term ( six weeks postoperatively), and no patient sought additional surgical treatment for the feet. At an average of 45 months follow-up postoperatively, the average AOFAS forefoot score was 82 points and the average hallux valgus angle was 16°. There were no reoperations and complication. Conclusions Using proper operation, patients with metatarsalgia and hallux valgus associated with rheumatoid arthritis can have an excellent result.
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