第一跖趾关节痛风石的手术治疗

目的探讨和总结跖趾关节巨大痛风石的治疗方法、疗效分析。方法对12例第一跖趾关节巨大痛风石患者，在综合治疗基础上，行手术治疗，术后长期监控血尿酸。结果本组12例，全部得到随访，随访时间6～24个月，平均13．4个月。关节切口Ⅰ期愈合，仅1例切口出现延迟愈合，占8．3％。术后跖趾关节外观和关节功能满意。结论积极的手术治疗是治疗第一跖趾关节巨大痛风石的有效方法，能减少痛风急性发作的次数，改善足的外观、保护足的功能。

Surgical treatment for first metatarsophalangeal joint tophi

Objective To analysis the clinical outcomes of surgical treatment for tophi at the first metatarsophalangeal joint. Methods 24 cases of patients with tophi at the first metatarsophalangeal joint were enrolled. On the basis of comprehensive treatment, surgical resection of the tophi was performed, and the serum uric acid was monitored after operation in long-term. Results Among the 24 cases, 21 cases were followed up for 6 to 24 months, with an average time of 13.4 months. The incision was primary healing in 20 cases, and there was one case of delayed union. After operation, the joint function was improved, the valgus deformity was corrected, and the acute gout attacks significantly reduced. Up to 96% of the patients were satisfied with the efficacy. Conclusions Aggressive surgical treatment is an effective treatment for the large tophi at the first metatarsophalangeal joint; it can not only reduce the number of gout, but also improve the foot appearance and protect the foot function.