Case Report

Treatment of an Intractable Forefoot Ulcer Using Realignment Osteotomy in a Patient with Rheumatoid Arthritis

Figure 1

Time course of radiographs of the right foot. At 61 years old, X-ray shows that the hallux valgus angle (HVA) is 29°, the interphalangeal angle between the first and second metatarsals (M1M2A) is 9°, and the interphalangeal angle between the first and fifth metatarsals (M1M5A) is 30° (a; anteroposterior view) (b; oblique view). Just before surgery at 76 years old, HVA is 50°, M1M2A is 15°, and M1M5A is 35°, respectively (c; anteroposterior view) (d; oblique view). Mitchell’s osteotomy for hallux and shortening oblique osteotomies for lesser toes were performed. Postoperative radiographs show that HVA is 19°, M1M2A is 7°, and M1M5A is 23°, respectively (e; anteroposterior view) (f; oblique view). Recent follow-up radiographs at 6 months after the surgery show that temporal Kirschner wires for lesser toes are removed and that each osteotomy site healed (g; anteroposterior view) (h; oblique view).
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