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Keller's arthroplasty: is distraction useful? A prospective trial
The Journal of Bone and Joint Surgery. British Volume
|November 1, 1984
Summary
Keller's operation is popular for hallux valgus and rigidus. A trial found no benefit from adding Kirschner-wire distraction, suggesting it may worsen joint degeneration and patient outcomes.
Area of Science:
- Orthopedic surgery
- Foot and ankle surgery
Background:
- Keller's operation is a common surgical procedure for hallux valgus and hallux rigidus.
- It is frequently chosen for elderly patients with these foot conditions.
Purpose of the Study:
- To compare the outcomes of standard Keller's operation versus a modified version using Kirschner-wire distraction.
- To evaluate the efficacy and potential complications of Kirschner-wire augmentation in Keller's procedure.
Main Methods:
- A prospective clinical trial was conducted.
- Patients underwent either standard Keller's operation or Keller's operation with temporary Kirschner-wire distraction.
- Outcomes were assessed to compare the two techniques.
Main Results:
- The addition of Kirschner-wire distraction provided no discernible advantage over the standard Keller's operation.
- The modified technique was associated with increased degenerative changes in the interphalangeal joint.
- Subjective patient outcomes were poorer in the group that received Kirschner-wire distraction.
Conclusions:
- Temporary Kirschner-wire distraction in Keller's operation does not improve results.
- This modification may lead to adverse effects, including joint degeneration and diminished patient satisfaction.
- The standard Keller's operation is recommended over the modified technique.