Surgical Tx of RA Flashcards
what are some typical forefoot deformities seen in RA?
- hyperpronation
- metatarsalgia
- MPJ dislocation
- hallux valgus
- claw toes
- hammer toes
what are some typical midfoot and rearfoot deformities seen with RA?
- TN arthritis
- STJ arthritis
- rupture of PTT
what are non-operative treatment options for RA?
- pharmacologic: NSAIDs, DMARDs, corticosteroids
- accommodative insoles
- AFO
- shoegear modifications: rocker bottom sole
what are the goals for surger y in a RA patient?
- pain relief
- improvement of overall function
- correction of deformity by increasing stability and overall muscle force
what is peri-op management of RA patients?
if 5mg, give regular dose + 25mg prior to srugery
do you stop DMARDs prior to surgery?
yes, stop 1-2 wks prior to sx
true or false: methotrexate DOES NOT need to be stopped prior to surgery
true
what other peri-op mgmt do you worry about for RA patient?
- prophylactic abx
- prophylaxis for DVT
- workup for atlantoaxial subluxation
- overall bone stock
what is a panmetatarsal head resection?
taking out met heads 2-5 followed with 1st MPJ arthroplasty or arthrodesis
which incisional approach for pan-met head resection is a plantar transverse incision?
Hoffman
which incisional approach for pan-met head resection is a three dorsal linear incision?
Larmon
which incisional approach for pan-met head resection is a 5-dorsal linear incision?
Hodor and Dobbs
which incisional approach for pan-met head resection is a dorsal longitudinal incision?
McKeever
which incisional approach for pan-met head resection is a dorsal transverse incision?
Clayton
which incisional approach for pan-met head resection is a one linear, two lazy S procedures?
Bilotti
