Abstract
Treatment of the rheumatoid forefoot involves resection arthroplasty of the MTP joints of the lesser toes. This can either involve resection of the metatarsal heads or, as described by Stainsby: resection of the proximal phalanx. The Stainsby procedure is a well accepted technique, however despite this there is very little information on the outcome of this procedure.
Materials and Methods
40 rheumatoid patients were treated with the Stainsby procedure, over a five year period. Preoperatively patients completed a Foot Function Index (FFI) and American Orthopaedic Foot and Ankle Score (AOFAS). The minimum follow-up was 12 months, range of follow-up 12–60 months. At follow-up review patients also completed the FFI and AOFAS. Therefore comparison of preoperative and postoperative scores was assessed.
Results
There was a great improvement in both FFI and AOFAS after the Stainsby procedure, especially in patients who also underwent arthrodesis of the first MTPJ. Statistical analysis of the results is presently being completed and the full results will be discussed at the meeting.
Discussion
Treatment of the rheumatoid forefoot involving resection of the metatarsal heads is a well known procedure, with much published literature to support its use. To date there is very little literature to assess the outcomes of performing a Stainsby procedure as an alternative resection arthroplasty.
This study highlights the comparable benefits and results of resecting the proximal phalanx and therefore preserving the metatarsal heads, as described by Stainsby.
