Resection arthroplasties of the metatasophalangeal joint were performed in 31 feet of 21 patients who had rheumatoid arthritis. Kates-Kessel-Kay arthroplasties were performed in 23 feet (16 cases), Clayton procedures in 5 feet (4 cases) and Keller procedures in 3 feet (2 cases) . The follow-up periods averaged 4.3 years.
The results were almost satisfactory with the Kates-Kessel-Kay and Clayton procedures, due to the relief of pain in spite of the recurrence of hallux valgus and hammer toe deformities. The Keller operation was the only available method for hallux valgus but in the course of RA suffering metatarso-phalangeal disorders of other toes progressed and metatarsalgia of other toes occurred.
For the purpose of the prevention of hallux valgus recurrence, we are now trying a Kates-Kessel-Kay procedure modified by transferring the adductor hallucis and flexor hallucis brevis to the 1st metatarsal excision stump.
