Objective:To study the imaging parameters of Chevron combined with Akin and Scarf combined with Akin for the correction of hallux valgus in patients of different ages.Methods:Eighty patients(152 feet)with hallux valgu...Objective:To study the imaging parameters of Chevron combined with Akin and Scarf combined with Akin for the correction of hallux valgus in patients of different ages.Methods:Eighty patients(152 feet)with hallux valgus who underwent Chevron combined with Akin and Scarf combined with Akin in our hospital were randomly selected.The patients were divided into young and middle-aged groups.Measure the hallux valgus angles(HVA),distal metatarsal articular angle(DMAA)and intermetatarsal angles(IMA)with professional X-ray measurement software and then reseach the effect of two the operation methods.Results:Young group:Chevron combined with Akin and Scarf combined with Akin significantly improved HVA and IMA,the difference had statistical significance(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).The improvement effect of the two groups on DMAA in young patients was not significant,and the difference had no statistical significance(P>0.05);Middle-aged group:Chevron combined with Akin and Scarf combined with Akin also significantly improved HVA and IMA(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).Chevron combined with Akin significantly improved DMAA in middle-aged and elderly patients,and the difference had statistical significance(P<0.05).Scarf combined with Akin did not significantly improve DMAA in middle-aged and elderly patients,and the difference had no statistical significance(P<0.05).Conclusion:Both Chevron combined with Akin and Scarf combined with Akin are effective and widely used.Chevron combined with Akin was able to improve DMAA in middle-aged and elderly patients.Therefore,Chevron combined with Akin is recommended for middle-aged and elderly patients with hallux valgus.展开更多
BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a def...BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical treatment.In this study,we attempted to develop a procedure for this condition.AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity.METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems.This method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction power.Preoperative,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical significance.RESULTS The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at M2.The mean follow-up duration was 11 months.All patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up.Randomized clinical trials with larger samples,as well as long-term outcome assessments,are needed in the future.展开更多
Objective: The aim of this study was to compare two different surgical techniques for treating mild to moderate cases of hallux valgus. Methods: Forty-one patients (58 feet) with mild to moderate hallux valgus were tr...Objective: The aim of this study was to compare two different surgical techniques for treating mild to moderate cases of hallux valgus. Methods: Forty-one patients (58 feet) with mild to moderate hallux valgus were treated by either percutaneous technique (n = 24) patients (33 feet) or by distal chevron osteotomy (n = 17) (25 feet). Results: In the percutaneous group, after a mean follow up of 49.36 months, the mean correction of hallux valgus angle (HV) was 26.69°in the intermetatarsal angle, average correction was 9.45°. The mean improvement of American Orthopedic Foot and Ankle Score (AOFAS) was 46.45 points. In the chevron osteotomy group, the mean follow up of 51.56 months, the mean correction of hallux valgus angle was 26.78°in the intermetatarsal angle, average correction was 9°. The mean improvement of AOFAS was 44.76 points. Conclusion: Both techniques gave satisfactory results. However, the percutaneous technique is safer than the distal chevron osteotomy.展开更多
Background: There are at least 5 very popular methods described for the correction of mild to moderate hallux valgus deformities. Despite of reported and self experienced good results in favorable fitting preoperative...Background: There are at least 5 very popular methods described for the correction of mild to moderate hallux valgus deformities. Despite of reported and self experienced good results in favorable fitting preoperative anatomical conditions of some of these methods;it seems that no one is really satisfying under “difficult” or non favorable preoperative anatomic conditions. How could an optimum operation method for a satisfying correction of a mild to moderate hallux valgus look like? The well known criteria for an optimally satisfying method to achieve full normalization of important forefoot parameters under all conditions should be a lateralization, plantarization and derotation of the Ist metatarsal head and also a normalization of the distal metatarsal articular angle (DMAA) in combination with a soft tissue correction. Methods: In order to achieve this outcome without the disadvantages of shortening or the need for unloading, we developed a new operation technique and new fixation devices. We performed a simple transverse lazy-L subcapital osteotomy and after an additional soft tissue release the Ist metatarsal head was restored to its preplaned optimum position in terms of narrowing the IM angle, plantarization, correction of the hallux valgus angle, derotation of a pronation l malrotation and improvement of the DMAA. Fixation was achieved with an intramedullary angel-stable transfixed 30 mm titanium plate. The rigidity of the implant rendered interfragmental compression or solid bone contact unnecessary. The goal was only an optimal correction. All patients were allowed to ambulate with full weightbearing immediately after the operation. Results: We retrospectively reviewed 346 patients (433 feet) who underwent subcapital osteotomy between May 2007 and December 2011;308 were women and 38 men;their mean age was 65 years. The follow-up investigation was performed on average after 6.5 years (78 months);range 5.5 to 10 years (66 to 120 months). The AOFAS Score improved from 61.18 to 96.82 (t = 55.13, p ° to 4.21° (t = 89.70, p ° to 7.75° (t = 51.68, p ° to 6.61° (t = 29.34, p < 0.001). Minimal shortening of the first metatarsal (0.33 mm) and no recurrence of the deformity was observed. Conclusion: A new access to hallux valgus surgery is presented. Our results show that interfragmental compression between the osteotomy partners or good interfragmental contact is not necessary when a rigid intramedullary fixation device is used. The goal of this approach to hallux valgus surgery was to achieve excellent correction and a very rigid intramedullary angle-stable locked implant. The procedure yielded excellent results and was associated with no recurrence of hallux valgus.展开更多
AIM:To define footwear outcomes following hallux valgus surgery,focusing on patient return to comfortable and heeled footwear and patterns of post-operative footwear selection.METHODS:Surgical intervention is indicate...AIM:To define footwear outcomes following hallux valgus surgery,focusing on patient return to comfortable and heeled footwear and patterns of post-operative footwear selection.METHODS:Surgical intervention is indicated for symptomatic cases of hallux valgus unresponsive to conservative methods,with favourable reported outcomes.The return to various types of footwear postoperatively is reflective of the degree of correction achieved,and corresponds to patient satisfaction.Patients are expected to return to comfortable footwear post-operatively without significant residual symptoms.Many female patients will additionally attempt to return to high-heeled,narrow toe box shoes.However,minimal evidence exists to guide their expectations.Sixtyfive female hallux valgus patients that had undergone primary surgery bet ween 2011 and 2013 were retrospectively identified using our hospital surgical database.Patients were reviewed using a footwearspecific outcome questionnaire at a mean 18.5 mo follow-up.RESULTS:Eighty-six percent of patients were able to return to comfortable footwear post-operatively with minimal discomfort.Of those intending to resume wearing heeled footwear,62%were able to do so,with 77%of these patients wearing these as or more frequently than pre-operatively.No significant difference was observed between pre-and post-operative heel size.Mean time to return to heeled footwear was 21.4wk post-operation.Cosmetic outcomes were very high and did not adversely impact footwear selection.CONCLUSION:We report high rates of return to both comfortable and heeled shoes in female patients following primary hallux valgus surgery.We observed an"all-ornone phenomenon"where patients rejected a return to heeled footwear unless able to tolerate them at the same frequency and heel size as pre-operatively.A minority of patients were unable to return to comfortable footwear post-operatively,which had adverse ramifications on their quality-of-life.We recommend that the importance of managing patient expectations through appropriate pre-operative counselling be emphasized in forefoot surgery.展开更多
Background: Moderate to severe hallux valgus deformity demands correction of the deformity. The purpose of the current study was to evaluate the results and advantages of the modified Wilson technique for treatment of...Background: Moderate to severe hallux valgus deformity demands correction of the deformity. The purpose of the current study was to evaluate the results and advantages of the modified Wilson technique for treatment of hallux valgus. Twenty four operations of distal oblique osteotomies on the first metatarsal bone as described by Wilson (1963) with some modifications were performed on fifteen patients suffering from hallux valgus, done in the Department of Orthopedic Surgery and Traumatology of El-Minia University Hospital;nine of them were bilateral and six were unilateral. The osteotomy site was fixed by K. wire after displacement of the distal fragment laterally and proximally. A below the knee plaster cast was applied and the patients were encouraged to bear weight partially after the second post-operative week. The K. wire was removed after 6 weeks and the cast was removed after 10 weeks. Excellent results occurred in 18 out of 24 feet operated (75%), good in 3 feet (12.5%), fair in 2 feet (8.33%) and poor in one case (4.17%). Conclusions: These modifications added more advantages to Wilson technique as a good procedure for treatment of hallux valgus.展开更多
Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However,...Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.展开更多
BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone...BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone,the synthesis or not of the metatarsal head,the possible association with lateral soft tissues release(LSTR)and osteotomy of the base of the first phalanx.AIM To evaluate the role of LSTR on percutaneous HV correction,evaluating functional and radiographical results.METHODS From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study.The technique provides no internal fixation(WOS).Patients were divided into the LSTR group and no LSTR group(LSTR N).This surgical procedure(LSTR)was reserved for insufficient HV angle(HVA)correction during fluoroscopic control.Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors(first practitioners).Clinical evaluation was performed before surgery,6 mo after surgery,and 48 mo follow-up.American Orthopaedic Foot and Ankle Society(AOFAS)and visual analog scale(VAS)score was used to evaluate pain and function,and complications were recorded.In addition,the incidence of relapses and the degree of joint range of motion(ROM)with the association with the LSTR(capsule,adductor tendon,phalanx-sesamoid ligament,and the deep transverse metatarsal ligament)were evaluated.Radiological parameters included HVA and intermetatarsal angle(IMA).Patient satisfaction was assessed.Student t-test and Fisher exact test were used to assess statistical analysis.RESULTS From our study it is clear that no differences in term of HVA,VAS,IMA correction,rate of complications,and AOFAS score were found between groups,while a significant improvement of the same variables was found in each group between pre and postoperative values.A significant improvement in ROM at 6 mo(P=0.018)and 48 mo(P=0.02)of follow-up was found in LSTR N group.Complications were rare in both groups.CONCLUSION LSTR procedure on percutaneous HV correction seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.展开更多
A minimally invasive surgical technique (MIS) is any procedure that could be less invasive than open surgery used for the same purpose. Though MIS often involves small incisions or percutaneous approaches, its main go...A minimally invasive surgical technique (MIS) is any procedure that could be less invasive than open surgery used for the same purpose. Though MIS often involves small incisions or percutaneous approaches, its main goal is to achieve good therapeutic results with the least damage to functional anatomic structures. Minimal invasiveness in orthopaedic forefoot surgery, including first ray and lesser toes, with its growth over the last two decade, showed many advantages and good outcomes with the aim to obtain fewer complications due to a contained approach, shorter surgical time and exposure, lesser post-operative risk of infection, lesser pain, hospitalization and post-operative recovery time, compared with traditional open approaches. This appears particularly true for what concerns hallux valgus surgical correction. MIS techniques have proven in the literature to be reliable, providing today comparable results with traditional open approaches.展开更多
目的探析微创Chevron-Akin截骨术治疗轻中度拇外翻的早期效果。方法选择自2022年1月至2024年6月淮阳楚氏骨科医院收治的61例轻中度拇外翻患者作为研究对象,均采取微创Chevron-Akin截骨术进行治疗,比较手术前后拇外翻角、美国骨科足踝外...目的探析微创Chevron-Akin截骨术治疗轻中度拇外翻的早期效果。方法选择自2022年1月至2024年6月淮阳楚氏骨科医院收治的61例轻中度拇外翻患者作为研究对象,均采取微创Chevron-Akin截骨术进行治疗,比较手术前后拇外翻角、美国骨科足踝外科协会(American Association of Orthopaedic and Ankle Surgeons,AOFAS)前足评分等情况。结果治疗后患者拇外翻角、第1、2跖骨间角较治疗前降低,差异有统计学意义(P<0.05)。治疗后患者AOFAS前足评分(88.64±3.08)分较治疗前(55.85±2.53)分明显提高,差异有统计学意义(P<0.05)。结论微创Chevron-Akin截骨术治疗轻中度拇外翻可明显改善拇外翻程度,恢复时间较短,且并发症少。展开更多
基金Planned project of Beijing municipal commission of science and technology(No.Z171100001017205)。
文摘Objective:To study the imaging parameters of Chevron combined with Akin and Scarf combined with Akin for the correction of hallux valgus in patients of different ages.Methods:Eighty patients(152 feet)with hallux valgus who underwent Chevron combined with Akin and Scarf combined with Akin in our hospital were randomly selected.The patients were divided into young and middle-aged groups.Measure the hallux valgus angles(HVA),distal metatarsal articular angle(DMAA)and intermetatarsal angles(IMA)with professional X-ray measurement software and then reseach the effect of two the operation methods.Results:Young group:Chevron combined with Akin and Scarf combined with Akin significantly improved HVA and IMA,the difference had statistical significance(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).The improvement effect of the two groups on DMAA in young patients was not significant,and the difference had no statistical significance(P>0.05);Middle-aged group:Chevron combined with Akin and Scarf combined with Akin also significantly improved HVA and IMA(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).Chevron combined with Akin significantly improved DMAA in middle-aged and elderly patients,and the difference had statistical significance(P<0.05).Scarf combined with Akin did not significantly improve DMAA in middle-aged and elderly patients,and the difference had no statistical significance(P<0.05).Conclusion:Both Chevron combined with Akin and Scarf combined with Akin are effective and widely used.Chevron combined with Akin was able to improve DMAA in middle-aged and elderly patients.Therefore,Chevron combined with Akin is recommended for middle-aged and elderly patients with hallux valgus.
文摘BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in women.The associated foot pain causes impaired gait and decreases quality of life.Moderate and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical treatment.In this study,we attempted to develop a procedure for this condition.AIM To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot deformity.METHODS We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated problems.This method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction power.Preoperative,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical significance.RESULTS The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at M2.The mean follow-up duration was 11 months.All patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed method showed good sustainability of correction power in a small sample of patients at the one-year follow-up.Randomized clinical trials with larger samples,as well as long-term outcome assessments,are needed in the future.
文摘Objective: The aim of this study was to compare two different surgical techniques for treating mild to moderate cases of hallux valgus. Methods: Forty-one patients (58 feet) with mild to moderate hallux valgus were treated by either percutaneous technique (n = 24) patients (33 feet) or by distal chevron osteotomy (n = 17) (25 feet). Results: In the percutaneous group, after a mean follow up of 49.36 months, the mean correction of hallux valgus angle (HV) was 26.69°in the intermetatarsal angle, average correction was 9.45°. The mean improvement of American Orthopedic Foot and Ankle Score (AOFAS) was 46.45 points. In the chevron osteotomy group, the mean follow up of 51.56 months, the mean correction of hallux valgus angle was 26.78°in the intermetatarsal angle, average correction was 9°. The mean improvement of AOFAS was 44.76 points. Conclusion: Both techniques gave satisfactory results. However, the percutaneous technique is safer than the distal chevron osteotomy.
文摘Background: There are at least 5 very popular methods described for the correction of mild to moderate hallux valgus deformities. Despite of reported and self experienced good results in favorable fitting preoperative anatomical conditions of some of these methods;it seems that no one is really satisfying under “difficult” or non favorable preoperative anatomic conditions. How could an optimum operation method for a satisfying correction of a mild to moderate hallux valgus look like? The well known criteria for an optimally satisfying method to achieve full normalization of important forefoot parameters under all conditions should be a lateralization, plantarization and derotation of the Ist metatarsal head and also a normalization of the distal metatarsal articular angle (DMAA) in combination with a soft tissue correction. Methods: In order to achieve this outcome without the disadvantages of shortening or the need for unloading, we developed a new operation technique and new fixation devices. We performed a simple transverse lazy-L subcapital osteotomy and after an additional soft tissue release the Ist metatarsal head was restored to its preplaned optimum position in terms of narrowing the IM angle, plantarization, correction of the hallux valgus angle, derotation of a pronation l malrotation and improvement of the DMAA. Fixation was achieved with an intramedullary angel-stable transfixed 30 mm titanium plate. The rigidity of the implant rendered interfragmental compression or solid bone contact unnecessary. The goal was only an optimal correction. All patients were allowed to ambulate with full weightbearing immediately after the operation. Results: We retrospectively reviewed 346 patients (433 feet) who underwent subcapital osteotomy between May 2007 and December 2011;308 were women and 38 men;their mean age was 65 years. The follow-up investigation was performed on average after 6.5 years (78 months);range 5.5 to 10 years (66 to 120 months). The AOFAS Score improved from 61.18 to 96.82 (t = 55.13, p ° to 4.21° (t = 89.70, p ° to 7.75° (t = 51.68, p ° to 6.61° (t = 29.34, p < 0.001). Minimal shortening of the first metatarsal (0.33 mm) and no recurrence of the deformity was observed. Conclusion: A new access to hallux valgus surgery is presented. Our results show that interfragmental compression between the osteotomy partners or good interfragmental contact is not necessary when a rigid intramedullary fixation device is used. The goal of this approach to hallux valgus surgery was to achieve excellent correction and a very rigid intramedullary angle-stable locked implant. The procedure yielded excellent results and was associated with no recurrence of hallux valgus.
文摘AIM:To define footwear outcomes following hallux valgus surgery,focusing on patient return to comfortable and heeled footwear and patterns of post-operative footwear selection.METHODS:Surgical intervention is indicated for symptomatic cases of hallux valgus unresponsive to conservative methods,with favourable reported outcomes.The return to various types of footwear postoperatively is reflective of the degree of correction achieved,and corresponds to patient satisfaction.Patients are expected to return to comfortable footwear post-operatively without significant residual symptoms.Many female patients will additionally attempt to return to high-heeled,narrow toe box shoes.However,minimal evidence exists to guide their expectations.Sixtyfive female hallux valgus patients that had undergone primary surgery bet ween 2011 and 2013 were retrospectively identified using our hospital surgical database.Patients were reviewed using a footwearspecific outcome questionnaire at a mean 18.5 mo follow-up.RESULTS:Eighty-six percent of patients were able to return to comfortable footwear post-operatively with minimal discomfort.Of those intending to resume wearing heeled footwear,62%were able to do so,with 77%of these patients wearing these as or more frequently than pre-operatively.No significant difference was observed between pre-and post-operative heel size.Mean time to return to heeled footwear was 21.4wk post-operation.Cosmetic outcomes were very high and did not adversely impact footwear selection.CONCLUSION:We report high rates of return to both comfortable and heeled shoes in female patients following primary hallux valgus surgery.We observed an"all-ornone phenomenon"where patients rejected a return to heeled footwear unless able to tolerate them at the same frequency and heel size as pre-operatively.A minority of patients were unable to return to comfortable footwear post-operatively,which had adverse ramifications on their quality-of-life.We recommend that the importance of managing patient expectations through appropriate pre-operative counselling be emphasized in forefoot surgery.
文摘Background: Moderate to severe hallux valgus deformity demands correction of the deformity. The purpose of the current study was to evaluate the results and advantages of the modified Wilson technique for treatment of hallux valgus. Twenty four operations of distal oblique osteotomies on the first metatarsal bone as described by Wilson (1963) with some modifications were performed on fifteen patients suffering from hallux valgus, done in the Department of Orthopedic Surgery and Traumatology of El-Minia University Hospital;nine of them were bilateral and six were unilateral. The osteotomy site was fixed by K. wire after displacement of the distal fragment laterally and proximally. A below the knee plaster cast was applied and the patients were encouraged to bear weight partially after the second post-operative week. The K. wire was removed after 6 weeks and the cast was removed after 10 weeks. Excellent results occurred in 18 out of 24 feet operated (75%), good in 3 feet (12.5%), fair in 2 feet (8.33%) and poor in one case (4.17%). Conclusions: These modifications added more advantages to Wilson technique as a good procedure for treatment of hallux valgus.
文摘Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.
文摘BACKGROUND In the field of minimally invasive surgery(MIS)for the treatment of hallux valgus(HV),different techniques have begun to emerge in the literature concerning the distal osteotomy of the first metatarsal bone,the synthesis or not of the metatarsal head,the possible association with lateral soft tissues release(LSTR)and osteotomy of the base of the first phalanx.AIM To evaluate the role of LSTR on percutaneous HV correction,evaluating functional and radiographical results.METHODS From January 2012 to May 2016 a total of 396 patients with mild to moderate symptomatic HV treated with the MIS technique were included in this retrospective study.The technique provides no internal fixation(WOS).Patients were divided into the LSTR group and no LSTR group(LSTR N).This surgical procedure(LSTR)was reserved for insufficient HV angle(HVA)correction during fluoroscopic control.Patients were evaluated at each follow-up by two other authors after appropriate training by senior authors(first practitioners).Clinical evaluation was performed before surgery,6 mo after surgery,and 48 mo follow-up.American Orthopaedic Foot and Ankle Society(AOFAS)and visual analog scale(VAS)score was used to evaluate pain and function,and complications were recorded.In addition,the incidence of relapses and the degree of joint range of motion(ROM)with the association with the LSTR(capsule,adductor tendon,phalanx-sesamoid ligament,and the deep transverse metatarsal ligament)were evaluated.Radiological parameters included HVA and intermetatarsal angle(IMA).Patient satisfaction was assessed.Student t-test and Fisher exact test were used to assess statistical analysis.RESULTS From our study it is clear that no differences in term of HVA,VAS,IMA correction,rate of complications,and AOFAS score were found between groups,while a significant improvement of the same variables was found in each group between pre and postoperative values.A significant improvement in ROM at 6 mo(P=0.018)and 48 mo(P=0.02)of follow-up was found in LSTR N group.Complications were rare in both groups.CONCLUSION LSTR procedure on percutaneous HV correction seems to increase postoperative joint stiffness with a comparable incidence of relapse and a low incidence of complications.
文摘A minimally invasive surgical technique (MIS) is any procedure that could be less invasive than open surgery used for the same purpose. Though MIS often involves small incisions or percutaneous approaches, its main goal is to achieve good therapeutic results with the least damage to functional anatomic structures. Minimal invasiveness in orthopaedic forefoot surgery, including first ray and lesser toes, with its growth over the last two decade, showed many advantages and good outcomes with the aim to obtain fewer complications due to a contained approach, shorter surgical time and exposure, lesser post-operative risk of infection, lesser pain, hospitalization and post-operative recovery time, compared with traditional open approaches. This appears particularly true for what concerns hallux valgus surgical correction. MIS techniques have proven in the literature to be reliable, providing today comparable results with traditional open approaches.
文摘目的探析微创Chevron-Akin截骨术治疗轻中度拇外翻的早期效果。方法选择自2022年1月至2024年6月淮阳楚氏骨科医院收治的61例轻中度拇外翻患者作为研究对象,均采取微创Chevron-Akin截骨术进行治疗,比较手术前后拇外翻角、美国骨科足踝外科协会(American Association of Orthopaedic and Ankle Surgeons,AOFAS)前足评分等情况。结果治疗后患者拇外翻角、第1、2跖骨间角较治疗前降低,差异有统计学意义(P<0.05)。治疗后患者AOFAS前足评分(88.64±3.08)分较治疗前(55.85±2.53)分明显提高,差异有统计学意义(P<0.05)。结论微创Chevron-Akin截骨术治疗轻中度拇外翻可明显改善拇外翻程度,恢复时间较短,且并发症少。
