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류마티스 관절염에 의한 고도의 무지 외반증과 소족지 갈퀴족 변형에 대한 중족골 종축 감압 절골술을 이용한 관절 보존술의 결과
Result of Joint Preserving Surgery Using Axial Shortening Metatarsal Osteotomy for the Treatment of Severe Hallux Valgus and Claw Toes Deformity in Advanced Rheumatoid Arthritis

대한족부족관절학회지 2012년 16권 1호 p.47 ~ p.52

남일현(Nam Il-Hyun) - 포항성모병원 정형외과
안길영(Ahn Gil-Yeong) - 포항성모병원 정형외과
문기혁(Moon Gi-Huk) - 포항성모병원 정형외과
이영현(Lee Yeong-Hyeon) - 포항성모병원 정형외과
최성필(Choi Seong-Pil) - 포항성모병원 정형외과
김호규(Kim Ho-Gyu) - 포항성모병원 정형외과
오동호(Oh Dong-Ho) - 포항성모병원 류마티스 내과

Abstract

Purpose: The purpose of this study is to evaluate the effect of axial shortening metatarsal osteotomy on the treatment of advanced rheumatoid arthritis patients with severe hallux valgus and claw toe deformity of lesser toes which is used for preserving the metatarsophalangeal joint.

Materials and Methods: From January 2005 to June 2009, 18 cases of axial shortening metatarsal osteotomy in advanced rheumatoid arthritis were reviewed ; all of them followed up for more than 2 years after surgical procedures and the mean follow up period was 3.4 years. We performed axial shortening Scarf osteotomy and Akin osteotomy for hallux valgus and Weil osteotomy with soft tissue release for claw toe of lesser toes, respectively. We measured preoperative and postoperative hallux valgus angle, each metatarsal shortening length and the range of motion of the metatarsophalangeal joints through radiographic and clinical examination and compared them each other. Clinical results were evaluated by American Orthopedic Foot and Ankle Society (AOFAS) score and subjective satisfaction of the patients.

Results: The hallux valgus angle was reduced from the preoperative mean value of 44.8 degree to 9.0 degree postoperatively and the range of motion of the metatarsophalangeal joint of great toe and lesser toes was increased from the mean of 21.7 degree and 11.0 degree preoperatively to 38.0 degree and 32.5 degree, respectively at postoperation. Also, the mean AOFAS score was improved from 26.5 points to 67.4 points.

Conclusion: Axial shortening osteotomy is a useful method to correct the deformity and preserve the metatarsophalangeal joint for severe hallux valgus and claw toe deformity in advanced rheumatoid arthritis.

키워드

Rheumatoid artrhritis, Hallux valgus, Claw toe, Scarf osteotomy, Weil osteotomy

KMID : 1130920120160010047

원문 및 링크아웃 정보

등재저널 정보

주제코드

주제명(Target field)

연구대상(Population)

연구참여(Sample size)

대상성별(Gender)

질병특성(Condition Category)

연구환경(Setting)

연구설계(Study Design)

연구기간(Period)

중재방법(Intervention Type)

중재명칭(Intervention Name)

키워드(Keyword)

유효성결과(Recomendation)

Axial shortening osteotomy is a useful method to correct the deformity and preserve the metatarsophalangeal joint for severe hallux valgus and claw toe deformity.

연구비지원(Fund Source)

근거수준평가(Evidence Hierarchy)

출판년도(Year)

참여저자수(Authors)

대표저자

DOI

KCD코드

ICD 03

건강보험코드