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Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity
BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP) joint has been recommended for severe hallux valgus deformity in patients with rheumatoid arthritis. We developed an alternative procedure that preserves motion of the first MTP joint while restoring alignment and balance to the forefoot...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Journal of Bone and Joint Surgery, Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319780/ https://www.ncbi.nlm.nih.gov/pubmed/30643665 http://dx.doi.org/10.2106/JBJS.ST.18.00004 |
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author | Hirao, Makoto Ebina, Kosuke Tsuboi, Hideki Nampei, Akihide Tsuji, Shigeyoshi Noguchi, Takaaki Owaki, Hajime Yoshikawa, Hideki Hashimoto, Jun |
author_facet | Hirao, Makoto Ebina, Kosuke Tsuboi, Hideki Nampei, Akihide Tsuji, Shigeyoshi Noguchi, Takaaki Owaki, Hajime Yoshikawa, Hideki Hashimoto, Jun |
author_sort | Hirao, Makoto |
collection | PubMed |
description | BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP) joint has been recommended for severe hallux valgus deformity in patients with rheumatoid arthritis. We developed an alternative procedure that preserves motion of the first MTP joint while restoring alignment and balance to the forefoot. This procedure was shown to be effective in a series of 60 patients with a 3-year follow-up. DESCRIPTION: We perform a modified Scarf osteotomy, with the longitudinal first metatarsal cut parallel to the sole of the foot and with shortening of the metatarsal to realign the first ray. This is combined with an interpositional capsular arthroplasty of the first MTP joint and shortening offset osteotomies of the lesser metatarsals. ALTERNATIVES: Alternatives include arthrodesis of the first MTP joint combined with resection arthroplasty of the lesser MTP joints, or of all 5 MTP joints, or perhaps interpositional (total) joint arthroplasty for severe rheumatoid forefoot deformity/destruction. RATIONALE: The purpose of the modified Scarf osteotomy is preservation of motion of the first MTP joint and protection against destruction of the rheumatoid joint. The metatarsal shortening offset osteotomy provides rigid stabilization at the site of osteotomy after dynamic correction to make the transverse arch. |
format | Online Article Text |
id | pubmed-6319780 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The Journal of Bone and Joint Surgery, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-63197802019-01-14 Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity Hirao, Makoto Ebina, Kosuke Tsuboi, Hideki Nampei, Akihide Tsuji, Shigeyoshi Noguchi, Takaaki Owaki, Hajime Yoshikawa, Hideki Hashimoto, Jun JBJS Essent Surg Tech Subspecialty Procedures BACKGROUND: Arthrodesis of the first metatarsophalangeal (MTP) joint has been recommended for severe hallux valgus deformity in patients with rheumatoid arthritis. We developed an alternative procedure that preserves motion of the first MTP joint while restoring alignment and balance to the forefoot. This procedure was shown to be effective in a series of 60 patients with a 3-year follow-up. DESCRIPTION: We perform a modified Scarf osteotomy, with the longitudinal first metatarsal cut parallel to the sole of the foot and with shortening of the metatarsal to realign the first ray. This is combined with an interpositional capsular arthroplasty of the first MTP joint and shortening offset osteotomies of the lesser metatarsals. ALTERNATIVES: Alternatives include arthrodesis of the first MTP joint combined with resection arthroplasty of the lesser MTP joints, or of all 5 MTP joints, or perhaps interpositional (total) joint arthroplasty for severe rheumatoid forefoot deformity/destruction. RATIONALE: The purpose of the modified Scarf osteotomy is preservation of motion of the first MTP joint and protection against destruction of the rheumatoid joint. The metatarsal shortening offset osteotomy provides rigid stabilization at the site of osteotomy after dynamic correction to make the transverse arch. The Journal of Bone and Joint Surgery, Inc. 2018-10-24 /pmc/articles/PMC6319780/ /pubmed/30643665 http://dx.doi.org/10.2106/JBJS.ST.18.00004 Text en Copyright © 2018 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Subspecialty Procedures Hirao, Makoto Ebina, Kosuke Tsuboi, Hideki Nampei, Akihide Tsuji, Shigeyoshi Noguchi, Takaaki Owaki, Hajime Yoshikawa, Hideki Hashimoto, Jun Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity |
title | Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity |
title_full | Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity |
title_fullStr | Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity |
title_full_unstemmed | Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity |
title_short | Modified Scarf Osteotomy with Medial Capsular Interposition in Great Toe and Metatarsal Shortening Offset Osteotomy in Lesser Toes for Rheumatoid Deformity |
title_sort | modified scarf osteotomy with medial capsular interposition in great toe and metatarsal shortening offset osteotomy in lesser toes for rheumatoid deformity |
topic | Subspecialty Procedures |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319780/ https://www.ncbi.nlm.nih.gov/pubmed/30643665 http://dx.doi.org/10.2106/JBJS.ST.18.00004 |
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