Forefoot amputation in rheumatoid arthritis

Five patients with long-standing rheumatoid arthritis underwent transmetatar-sal amputation. Operative indications were severe pain on walking, marked deformity of the forefoot, and no effect of conservative treatment. After a median follow-up time of 7 (1-12) years, 4 patients had no pain, all patients could wear normal shoes, and the gait was significantly improved without imbalance.