kellers procedure

Rheumatoid Foot & Ankle

Disorder of immune system

- antigen-antibody complexes

- stimulate release of proteolytic enzymes

- leading to vasculitis, synovitis and cartilage destruction

Articular Effects

- synovitis

- ligamentous and capsular laxity

- cartilage destruction

- osseous erosion

Vasculitis

- rheumatoid nodules

Painful restriction of dorsiflexion of the great toe

- secondary to degenerative changes in MTPJ

- initially pain and synovitis

- osteophytes don't form medially or on plantar aspect

Two peaks

1. Adolescence F > M

2. Middle Age M > F

Often Idiopathic

Trauma