53-year-old woman with continued pain after first metatarsophalangeal arthroplasty

摘要

A 53-year-old woman with rheumatoid arthritis on oral prednisone presented to a podiatric surgeon after a lifelonghistory of hallux valgus and lesser toe deformities. After failure of conservative management options, she opted forsurgical management with first metatarsophalangeal joint arthroplasty with a double-stem silastic implant.Hammertoe deformities of her second through fifth digits were treated with lesser metatarsal head resections withtransarticular pin fixation. The patient’s postoperative period was unremarkable, but after about 2 months, shenoticed recurrence of the deformity of the lesser toes. She also developed a painful plantar prominence at thehallux metatarsophalangeal with return of the valgus deformity. After 4 years of persistent pain, she was referred toorthopedic surgery for further evaluation.