Rheumatoid forefoot deformity: a comparison study of 2 functional methods of reconstruction.
Notice bibliographique
Résumé
OBJECTIVE: To compare the functional, radiographic, and pedobarographic results of different reconstructive methods for severe rheumatoid forefoot deformities. METHODS: A total of 138 feet in 79 patients with RA forefoot reconstructions between 1978 and 1997 were reviewed through a detailed questionnaire, clinical examination, standardized radiographs, and pedobarographic analysis. Five subgroups based on procedure to the 1st ray were identified, then divided into 2 functional categories: Group 1: stable 1st ray by means of arthrodesis or no surgery; and Group 2: a resection procedure to 1st metatarsophalangeal (MTP) joint. RESULTS: Sixty-one patients (106 feet) attended clinical review; 18 returned the questionnaire. There were 65 women and 14 men, with a mean age of 59 years (range 24-80): with 52 feet in Group 1 and 86 feet in Group 2. Mean age at surgery for both groups was 52 years (range 23-79). Mean age at the time of review was 55 years (Group 1) and 60.5 years (Group 2). Length of followup was significantly different: Group 1 averaged 36 months; Group 2, 102 months (p < 0.001). At review, no significant difference was noted in SF-36, comorbidities, WOMAC, or Foot Function Index. The disability score as defined by the American Rheumatological Society was significantly different: Group 1, 2.1 +/- 0.5; and Group 2, 2.4 +/- 0.6 (p = 0.006). Group 1 did significantly better in terms of walking distance, satisfaction with postoperative appearance of foot, relief of plantar pain, less plantar calluses, and higher AOFAS HMIP and LMIP scores. Postoperative complications occurred in 16 feet (11%); 15 feet required reoperation (10.6%). Major resection of the 1st MTP joint was associated with a significant increase in the 1st and 2nd intermetatarsal angle on radiographic review. The pattern of pressure distribution on the plantar aspect was similar regardless of the surgical procedure. The maximum contact area, maximum peak pressure, and maximum pressure time integral were located under the region of the 1st metatarsal, with a progressive decrease in values under the more lateral rays and under the lesser toes. Significantly higher pressures were seen under the 1st, 2nd, and 3rd metatarsal regions in Group 2 (1st MTP joint resection). Toe function was absent or minimal in the majority of Group 2. CONCLUSION: Forefoot arthroplasty by means of a resection or stabilization provides significant pain relief. Maintenance of a stable 1st MTP joint and resection of the lesser metatarsal heads with K-wire stabilization will result in a more cosmetic forefoot, more even distribution of forefoot pressures, and more satisfied patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».