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Salvage of a failed Keller resection arthroplasty.

Publication ,  Journal Article
Machacek, F; Easley, ME; Gruber, F; Ritschl, P; Trnka, H-J
Published in: J Bone Joint Surg Am
June 2004

BACKGROUND: A number of typical complications have been associated with Keller resection arthroplasty. Recurrent valgus deformity, cock-up deformity, and a flail toe may be difficult problems for the treating surgeon because options for salvage are limited. In this study, we evaluated arthrodesis of the first metatarsophalangeal joint as a salvage technique following a failed Keller procedure. In addition, the outcomes of motion-preserving procedures were reviewed in a separate series. METHODS: Arthrodesis of the first metatarsophalangeal joint was performed in twenty-eight patients (twenty-nine feet, group A), and either a repeat Keller procedure or an isolated soft-tissue release was performed in eighteen patients (twenty-one feet, group B). The patients were evaluated at least twenty-four months postoperatively, with a personal interview and a clinical examination with use of a modification of the hallux metatarsal-interphalangeal scale. Radiographs were also made for the group treated with the arthrodesis. RESULTS: In group A, the average duration of follow-up was thirty-six months and fusion was achieved in twenty-six of the twenty-nine feet. Satisfaction was excellent or good in twenty-three cases, and the postoperative score according to the modified hallux metatarsal-interphalangeal scale averaged 76 points (maximum, 90 points). A repeat arthrodesis was necessary in five feet because of malposition or pseudarthrosis. In group B, the average duration of follow-up was seventy-four months. Satisfaction was excellent or good in only six cases, and the patient was dissatisfied in eleven cases. The score according to the modified hallux metatarsal-interphalangeal scale averaged 48 points. Valgus deviation and cock-up deformity had recurred in the majority of the feet at the time of follow-up. CONCLUSIONS: Although it is more technically demanding, we recommend arthrodesis for salvage following a failed Keller procedure since it may be associated with a higher rate of patient satisfaction and better clinical results.

Duke Scholars

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Published In

J Bone Joint Surg Am

DOI

ISSN

0021-9355

Publication Date

June 2004

Volume

86

Issue

6

Start / End Page

1131 / 1138

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Treatment Failure
  • Toes
  • Time Factors
  • Salvage Therapy
  • Retrospective Studies
  • Reoperation
  • Patient Satisfaction
  • Orthopedics
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Machacek, F., Easley, M. E., Gruber, F., Ritschl, P., & Trnka, H.-J. (2004). Salvage of a failed Keller resection arthroplasty. J Bone Joint Surg Am, 86(6), 1131–1138. https://doi.org/10.2106/00004623-200406000-00003
Machacek, Felix, Mark E. Easley, Florian Gruber, Peter Ritschl, and Hans-Jörg Trnka. “Salvage of a failed Keller resection arthroplasty.J Bone Joint Surg Am 86, no. 6 (June 2004): 1131–38. https://doi.org/10.2106/00004623-200406000-00003.
Machacek F, Easley ME, Gruber F, Ritschl P, Trnka H-J. Salvage of a failed Keller resection arthroplasty. J Bone Joint Surg Am. 2004 Jun;86(6):1131–8.
Machacek, Felix, et al. “Salvage of a failed Keller resection arthroplasty.J Bone Joint Surg Am, vol. 86, no. 6, June 2004, pp. 1131–38. Pubmed, doi:10.2106/00004623-200406000-00003.
Machacek F, Easley ME, Gruber F, Ritschl P, Trnka H-J. Salvage of a failed Keller resection arthroplasty. J Bone Joint Surg Am. 2004 Jun;86(6):1131–1138.
Journal cover image

Published In

J Bone Joint Surg Am

DOI

ISSN

0021-9355

Publication Date

June 2004

Volume

86

Issue

6

Start / End Page

1131 / 1138

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Treatment Failure
  • Toes
  • Time Factors
  • Salvage Therapy
  • Retrospective Studies
  • Reoperation
  • Patient Satisfaction
  • Orthopedics
  • Middle Aged