Effect of combined treatment of the first metatarsophalangeal joint fusion with the second to fifth metatarsophalangeal arthroplasty on rheumatoid forefoot deformity

Objective To analyze the effect of the first metatarsophalangeal joint fusion combined with 2-5 metatarsophalangeal arthroplasty in the treatment of rheumatoid foot deformity. Methods From January 2015 to December 2019, 21 patients (36 feet) who have rheumatoid anterior foot deformity, with an average age of 63.6±6.0 years, were performed first metatarsophalangeal joint fusion and 2-5 metatarsophalangeal arthroplasty. The results of the operation were evaluated by the American Orthopaedic Foot and Ankle Society (AOFAS) scores and visual analog scale (VAS). The hallux valgus angle (HVA) and the intermetatarsal angle (IMA) were measured on the X-ray pre-operative and post-operative films. Results The follow-up period of 21 cases (36 feet) was 39.2±5.1 months, without any complication. The preoperative and postoperative scores of AOFAS, VAS, HVA and IMA were 81.6±9.1, 8.4±1.1, 37.2 °±7.5 °, 16.9 °±2.7 °,and 84.25±2.87, 1.9±0.9, 14.4 °±2.0 °, 11.1 °±1.7 ° respectively. The improvement was statistically significan