Rink-Brüne Oda
Department of Surgery, St. Josefs-Hospital, Bochum, Germany.
J Foot Ankle Surg. 2004 Sep-Oct;43(5):290-5. doi: 10.1053/j.jfas.2004.07.007.
One hundred six patients who underwent a Lapidus arthrodesis for a symptomatic hallux valgus deformity, mainly with first ray hypermobility, were retrospectively reviewed. Radiograph and chart reviews were performed in addition to a patient survey completed at a mean 17 months postoperatively. Of the 78 patients who completed the survey, 70.5% were satisfied with the procedure; 80.2% would choose the same method again. Seven percent of patients were dissatisfied. Review of preoperative and 3-month postoperative radiographs showed a mean intermetatarsal angle reduction of 12.4 degrees . The average postoperative sesamoid position was 2.5, a 4.0 reduction from the preoperative mean value of 6.5. The complication rate was 5.7%, including 2 nonunions (1.8%) requiring a repeat surgery, 1 deep-vein thrombosis (0.9%), and 3 patients with complex regional-pain syndrome (2.7%). In 16% of patients, resolution of swelling and subjective complaints took longer than 3 months; 4.7% of patients developed sesamoiditis or metatarsalgia that resolved with conservative measures. Radiographic undercorrection was evident in 4.7% of patients. The results showed that the Lapidus procedure provided reliable correction in cases of severe hallux valgus with intermetatarsal angles >15 degrees and in those patients with first ray hypermobility.
对106例行Lapidus关节融合术治疗症状性拇外翻畸形（主要伴有第一跖骨过度活动）的患者进行了回顾性研究。除了在术后平均17个月完成的患者调查外，还进行了X线片和病历回顾。在完成调查的78例患者中，70.5%对该手术满意；80.2%会再次选择相同的方法。7%的患者不满意。术前和术后3个月X线片回顾显示，跖间角平均减小12.4度。术后籽骨平均位置为2.5，较术前平均值6.5降低了4.0。并发症发生率为5.7%，包括2例骨不连（1.8%）需要再次手术、1例深静脉血栓形成（0.9%）和3例复杂性区域疼痛综合征患者（2.7%）。16%的患者肿胀消退和主观症状缓解时间超过3个月；4.7%的患者出现籽骨炎或跖痛症，经保守治疗后缓解。4.7%的患者X线片显示矫正不足。结果表明，Lapidus手术在跖间角>15度的重度拇外翻病例以及第一跖骨过度活动的患者中提供了可靠的矫正。
