Metatarsophalangeal dislocation in rheumatoid arthritis
A common complication of rheumatoid arthritis of the feet is dislocation of the metatarsophalangeal joints:
- the phalanges migrate dorsally
- bone destruction allows the protective fibrous pads, which usually protect the skin below the metatarsal heads, to slip forwards
- the metatarsal heads come to rest on atrophic tendons and fragile skin
- wear and tear results in wounds which rapidly erode down to bone
The usual treatment is forefoot arthroplasty, where all the metatarsal heads are removed.
This reliable operation gives good longterm results.
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