Comput. Aided Surg. - Computer assisted planning and custom-made surgical guide for malunited pronation deformity after first metatarsophalangeal joint arthrodesis in rheumatoid arthritis: a case report.

Tópicos

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Resumo

Arthrodesis of the first metatarsophalangeal (MTP-1) joint is a widely used procedure for the treatment of hallux valgus in patients with MTP-1 degeneration, severe or recurrent deformity, or inflammatory arthritis. In this case, ten years earlier, the patient's MTP-1 joint had been fused in a severe pronation deformity position. Subsequently, a laterally shifted tibial sesamoid and osseous rising of the phalanx base caused painful callosities. To correct the pronated deformity accurately, a custom-made surgical guide based on a three-dimensional computer tomography (3D-CT) simulation system was used. After correction of the deformity, the MTP-1 joint was again fused. Adequate correction was achieved, and the patient no longer complains of pain and can perform full weight-bearing on the forefoot. The difficulty and importance of placing the MTP-1 joint in an adequate rotational position in MTP-1 joint arthrodesis surgery were confirmed, as was the utility of 3D evaluation and a custom-made surgical guide for rotational adjustment between the metatarsal and the proximal phalanx. We believe that this system should be one of the indicators for adjusting the rotation, especially in revision MTP-1 joint fusion surgery.

Resumo Limpo

arthrodesi first metatarsophalang mtp joint wide use procedur treatment hallux valgus patient mtp degener sever recurr deform inflammatori arthriti case ten year earlier patient mtp joint fuse sever pronat deform posit subsequ later shift tibial sesamoid osseous rise phalanx base caus pain callos correct pronat deform accur custommad surgic guid base threedimension comput tomographi dct simul system use correct deform mtp joint fuse adequ correct achiev patient longer complain pain can perform full weightbear forefoot difficulti import place mtp joint adequ rotat posit mtp joint arthrodesi surgeri confirm util d evalu custommad surgic guid rotat adjust metatars proxim phalanx believ system one indic adjust rotat especi revis mtp joint fusion surgeri

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