Advertisement

Der Vorfuß bei Patienten mit rheumatoider Arthritis

  • A. CracchioloIII

Zusammenfassung

Die rheumatoide Arthritis (RA) ist eine systemische Erkrankung, die häufig den Fuß miterfaßt.Da es am Fuß zahlreiche synoviale Gelenke gibt, erzeugt die aktive rheumatische Erkrankung u. U. Schmerzen im gesamten Fuß Die Gelenkschwellung läßt sich am besten am Vorfuß und an den metatarsophalangealen (MTP-) Gelenken sehen. Obwohl die genaue Inzidenz der rheumatoiden Arthritis am Fuß und Sprunggelenk nicht bekannt ist, gibt es diesbezüglich geographische Unterschiede. So wird z. B. von einer Sprunggelenkbeteiligung in 68% der Fälle in Europa, dagegen nur in 10-15% der Fälle in den Vereinigten Staaten berichtet. Operationen sind bei Patienten mit entzündlichen Gelenkerkrankungen häufig.Sie werden auf 1/5 bis 1/3 aller durchgeführten Operationen geschätzt. Am Vorfuß werden wahrscheinlich 4- bis 5mal mehr Operationen als an Rückfuß und Sprunggelenk ausgeführt.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Amuso SJ, Wissinger HA, Margolis HM, Eisenbeis CH jr, Stolzer BL (1971) Metarsal head resection in the treatment of rheumatoid arthritis. Clin Orthop 74:94–100PubMedGoogle Scholar
  2. 2.
    Auerbach MD, Shepard E, Vernon-Roberts B (1982) Morton’s metarsalgia due to intermetatarso-phalangeal bursitis as an early manifestation of rheumatoid arthritis. Clin Orthop 167:214Google Scholar
  3. 3.
    Barton NJ (1973) Arthroplasty of the forefoot in rheumatoid arthritis. J Bone Joint Surg [Br] 52:126Google Scholar
  4. 4.
    Clayton ML (1982) Evolution of surgery of the forefoot in rheumatoid arthritis. J Bone Joint Surg [Br] 64:640Google Scholar
  5. 5.
    Clayton ML, Smyth CJ (1992) Surgery for rheumatoid arthritis. Churchill Livingstone, New YorkGoogle Scholar
  6. 6.
    Cracchiolo A, Cimino WR, Lian G (1992) Arthrodesis of the ankle in patients who have rheumatoid arthritis. J Bone Joint Surg [Am] 74 6:903–909Google Scholar
  7. 7.
    Cracchiolo A (1979) The use of shoes to treat foot disorders. Orthop Rev 8:73Google Scholar
  8. 8.
    Cracchiolo A (1982) Management of the arthritic forefoot. Foot Ankle Int 3:17–23Google Scholar
  9. 9.
    Cracchiolo A (1982) Office Practice: Footware and arthritic therapy. Foot Ankle Int 24:242–248Google Scholar
  10. 10.
    Cracchiolo A (1984) Surgery for rheumatoid disease. A AOS Instruc. Course Lecture. Mosby Times Mirror 33:386Google Scholar
  11. 11.
    Cracchiolo A (1988) Rheumatoid arthritis of the foot and ankle. In: Gould MD (ed) The foot book, chapt 8, part 4. Williams & Wilkins, Baltimore, Maryland, p 267Google Scholar
  12. 12.
    Cracchiolo A, Swanson A, Swanson GD (1981) The arthritic great toe metatarsophalangeal joint: A review of flexible silicone implant arthroplasty from two medical centers. Clin Orthop 157:64PubMedGoogle Scholar
  13. 13.
    Cracchiolo A, Weltmann JB, Lian G, Dalseth T, Dorey F (1992) Arthroplasty of the first metatarsophalangeal joint with a double stem silicone implant: Results in patients who have degenerative joint disease, failures of previous operation in rheumatoid arthritis. J Bone Joint Surg [Am] 74:552–563Google Scholar
  14. 14.
    Cracchiolo A (1993) The rheumatoid foot and ankle: Pathology and treatment. Foot 3: 126–134CrossRefGoogle Scholar
  15. 15.
    Craxford AD, Stevens J, Park C (1982) Management of the deformed rheumatoid forefoot: A comparison of conservative and surgical methods. Clin Orthop 166:121–126PubMedGoogle Scholar
  16. 16.
    Daly PJ, Johnson KA (1992) Treatment of painful subluxation or dislocated at the second and third metatarsophalangeal joints by partial proximal phalnx excision and subtotal webbing. Clin Orthop 278:164–170PubMedGoogle Scholar
  17. 17.
    Dedrich DK, McCune WS, Smith WS (1990) Rheumatoid arthritis presenting as spreading of the toes. J Bone Joint Surg [Am] 72/3:463–464Google Scholar
  18. 18.
    Faithful DK, Savill DL (1971) Review of the results of excision of metatarsal heads in patients with rheumatoid arthritis. Ann Rheum Dis 30:201–202PubMedCrossRefGoogle Scholar
  19. 19.
    Fowler AW (1959) The method forefoot reconstruction. J Bone Joint Surg [Br] 41:507Google Scholar
  20. 20.
    Gainor BJ, Epstein RG, Henstorf JE, Olson S (1988) Metarsal head resection for rheumatoid deformities of the forefoot. Clin Orthop 230:207–213PubMedGoogle Scholar
  21. 21.
    Geppert MJ, Sobel M, Bohne WHO (1992) The rheumatoid foot part I: Forefoot. Foot Ankle Int 13/9:550–558Google Scholar
  22. 22.
    Hassalo LG, Wilkens RF, Toomey HE, Darges DE, Hansen ST (1987) Forefoot surgery in rheumatoid arthritis: Subjective assessment of outcomes. Foot Ankle Int 8:148–151Google Scholar
  23. 23.
    Hughes J, Grace D, Clark P, Klenermann L (1991) Metarsal head excision for rheumatoid arthritis: 4-year-follow-up of 68 feet with and without hallux fixion. Acta Orthop Scand 62:63–66PubMedCrossRefGoogle Scholar
  24. 24.
    Kates A, Kessel L, Kay A (1967) Arthroplasty of the forefoot. J Bone Joint Surg [Br] 49:552Google Scholar
  25. 25.
    Lipscomb PR, Benson GM, Sones DA (1972) Resection of proximal phalanges and metatarsal condyles for deformities of the forefoot due to rheumatoid arthritis. Clin Orthop 82:24–31PubMedGoogle Scholar
  26. 26.
    Mann RA, Thompson FM (1984) Arthrodesis of the first metatarsophalangeal joint for hallux valgus in rheumatoid arthritis. J Bone Joint Surg [Am] 66:687–692Google Scholar
  27. 27.
    McGarvey SR, Johnson KA (1988) Keller arthroplasty in combination with resection arthroplasty of the lesser metatarsophalangeal joints in rheumatoid arthritis. Foot Ankle Int 92:85–90Google Scholar
  28. 28.
    Moeckel BJ, Sculco TP, Alexiades MM, Dossick PH, Inngles AE, Ranawat CS (1992) The double-stem silicone-rubber implant fur rheumatoid arthritis of the first metatarsophalangeal joint: Long term results. J Bone Joint Surg [Am] 75/4:564–570Google Scholar
  29. 29.
    Morgan CD, Henke JA, Bailey RW, Kaufer H (1985) Long term results of tibiotalar arthrodesis. J Bone Joint Surg [Am] 67:546Google Scholar
  30. 30.
    Newman RJ, Fitton JM (1983) Conservation of metatarsal head in surgery of rheumatoid arthritis of die forefoot. Acta Orthop Scand 54:417–421PubMedCrossRefGoogle Scholar
  31. 31.
    Raunio P, Lehtimaki M, Eerola M, Hamalainen M, Pulkki T (1987) Resection arthroplasty versus arthrodesis of the first metatarsophalangeal joint for hallux valgus in rheumatoid arthritis. Rheumatology 11:173–178Google Scholar
  32. 32.
    Refior HJ, Hoos R (1987) Midterm results of arthroplasty of the forefoot by Clayton-Vainio in rheumatoid arthritis. Rheumatology 11:131–135Google Scholar
  33. 33.
    Saltzmann CL, Johnson KA, Donnelly RE (1993) Surgical treatment for mild deformities of the rheumatoid forefoot by partial phalangectomy and syndactylization. Foot Ankle Int 146:325–329Google Scholar
  34. 34.
    Shepard E (1975) Intermetatarso-phalangeal bursitis in the causation of Morton’s metatarsalgia. In: Proceedings of the British Orthopaedic Association. J Bone Joint Surg [Br] 57/1:115–116Google Scholar
  35. 35.
    Spiegel TM, Spiegel JS (1982) Rheumatoid arthritis in the foot and ankle-diagnosis, pathology and treatment. Foot Ankle Int 2/6:318–324Google Scholar
  36. 36.
    Stockey I, Betts RP, Eng C, Getty CJM, Rowley DI, Duckworth T (1989) A prospective study of forefoot arthroplasty. Clin Orthop 248:213–218Google Scholar
  37. 37.
    Swanson AB, deGroot, Swanson G, Frisch EE (1983) Flexible (silicone) implant arthroplasty in the small joints of the extremities: Concepts, physical and biological considerations, experimental and clinical results. In: Rubin LR (ed) Biomaterials and reconstructive surgery. Mosby, St Louis, pp 595–623Google Scholar
  38. 38.
    Tillmann K (1979) The rheumatoid foot. Thieme, Stuttgart, S 1–116Google Scholar
  39. 39.
    Vahvanen V, Piirainen H, Kettunen P (1989) Resection arthroplasty of the metatarsophalangeal joints in rheumatoid arthritis: A follow-up study of 100 patients. Scand J Rheumatol 9:257–265CrossRefGoogle Scholar
  40. 40.
    Watson MS (1974) A long-term follow-up of forefoot arthroplasty. J Bone Joint Surg [Br] 56:527–533Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1996

Authors and Affiliations

  • A. CracchioloIII

There are no affiliations available

Personalised recommendations