Shortening Of The Metatarsal Proximal Oblique Cut Bone Reduction Treatment Severe Plantar Toe Joint Merger Plantar Painful Disease Clinical Analysis

1.ObjectiveTo analyze the effectiveness and security of metatarsal proximal osteotomy and shortening surgery in the treatment of the dislocation of severe metatarsophalangeal joint with plantar pain through the retrospective study.2.MethodThe cases in research are the patients who receive the treatment in Joint Departments II of Wangjing Hospital from October2005to March2011.Patients’age66.97±9.03years, male to female ratio2:21, a total of69patients,80feet (left40right40),89cases of metatarsophalangeal joints,74cases of the second metatarsophal-angeal joints (left39, right35),15cases of the third metatarsophalangeal joints (left5, right10).Postoperative follow-up time12to72months, the average of follow-up time32months. After the long-term follow-up,65paitiets in case left include74feet (left36, right38),83cases of metatarsophalangeal joints,68cases of the second metata-rsophalangeal joints (left35, right33),15cases of the third metatarsophalangeal joints (left5, right10), to observe and analyze the hallux valgus angle, intermetatarsal angle, metatarsal length, the metatarsophalangeal, joint gap, the metatarsus phalanx angle before and after surgery. AOFAS, ACFAS and VAS in the clinical evaluation were all analyzed to verify the validity of the technology before and after surgery.3Results3.1.X-ray indicatorsThe HAV, IM, metatarsal length, metatarsus phalanx angle, and metatarsophalangeal joint gap were all statistically significant before and after surgery(P<0.05).3.2The clinical efficacyThe treatment of severe metatarsophalangeal joint dislocation with plantar pain is effective in clinical validation after the long-term follow-up. The preoperative AOFAS score (35.49±6.01) and postoperative AOFAS score (91.29±3.77).The AOFAS score was statistically significant (P<0.05) before and after surgery. The Preoperative ACFAS score (34.06±7.54) and postoperative ACFAS score (90.43±3.88).The ACFAS score was statistically significant (P<0.05) before and after surgery. The Preoperative VAS score (8.14±0.97) and postoperative VAS score (1.14±0.73), The VAS score was statistically significant (P<0.05) before and after surgery.4ConclusionMetatarsal proximal osteotomy and shortening surgery in the treatment of the dislocation of severe metatarsophalangeal joint with plantar pain is very effective. The treatment of the dislocation of severe metatarsophalangeal joint with plantar pain can both correct the deformity of metatarsophalangealjoint dislocation, improve the forefoot pain symptom, and prove the effectiveness of the clinical treatment of the surgery.