JBJS essential surgical techniques · 2015
Arthrodesis of the Hallux Metatarsophalangeal Joint.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Wagner Emilio, Wagner Pablo, Ortiz Cristian
Аннотация
INTRODUCTION: Arthrodesis of the first metatarsophalangeal joint is the most reliable surgical option, with a low complication rate, for hallux rigidus from end-stage osteoarthritis.
STEP 1 SURGICAL APPROACH: Make a medial approach, following the mid-axis of the joint.
STEP 2 JOINT PREPARATION: Using a cup-cone configuration provides excellent bone exposure, construct stability, and metatarsophalangeal joint congruity.
STEP 3 POSITIONING OF ARTHRODESIS: Fix the toe in 5° to 10° of valgus and elevated 5 mm from the floor to achieve desired dorsiflexion.
STEP 4 APPLICATION OF IMPLANTS: Achieve a stable construct with a crossed lag screw and a dorsal locking plate (a hybrid construct).
STEP 5 CLOSURE: Perform a standard soft-tissue closure.
STEP 6 POSTOPERATIVE CARE: Allow weight-bearing as tolerated after two weeks and impact exercises only after bone healing has been shown on radiographs, which can take up to ten weeks.
RESULTS: Arthrodesis of the metatarsophalangeal joint in the hallux provides good results in terms of patient satisfaction and function, as demonstrated in many studies, most of them retrospective.IndicationsContraindicationsPitfalls & Challenges.
STEP 1 SURGICAL APPROACH: Make a medial approach, following the mid-axis of the joint.
STEP 2 JOINT PREPARATION: Using a cup-cone configuration provides excellent bone exposure, construct stability, and metatarsophalangeal joint congruity.
STEP 3 POSITIONING OF ARTHRODESIS: Fix the toe in 5° to 10° of valgus and elevated 5 mm from the floor to achieve desired dorsiflexion.
STEP 4 APPLICATION OF IMPLANTS: Achieve a stable construct with a crossed lag screw and a dorsal locking plate (a hybrid construct).
STEP 5 CLOSURE: Perform a standard soft-tissue closure.
STEP 6 POSTOPERATIVE CARE: Allow weight-bearing as tolerated after two weeks and impact exercises only after bone healing has been shown on radiographs, which can take up to ten weeks.
RESULTS: Arthrodesis of the metatarsophalangeal joint in the hallux provides good results in terms of patient satisfaction and function, as demonstrated in many studies, most of them retrospective.IndicationsContraindicationsPitfalls & Challenges.