Myerson M, Allon S, McGarvey W
Union Memorial Hospital, Baltimore, Maryland 21218.
Foot Ankle. 1992 Mar-Apr;13(3):107-15. doi: 10.1177/107110079201300301.
Sixty-seven closing wedge arthrodesis procedures of the first metatarsocuneiform joint were performed in 41 females and 12 males. Follow-up averaged 28 months (range 16-49 months) and was performed in 51 of 53 patients with a questionnaire, clinical examination, and comparison of pre- and postoperative weightbearing radiographs. The average hallux valgus angle was 34.5 degrees (range 20 degrees-75 degrees) and was corrected to 13.0 degrees (range-10 degrees-22 degrees) postoperatively. The average intermetatarsal angle was 14.3 degrees (range 9.5 degrees-34 degrees) and was corrected to an average of 5.8 degrees (range 0 degrees-12 degrees) postoperatively. Complications included seven superficial pin tract infections, three symptomatic dorsal bunions, one of which required repeat surgery, seven nonunions, one of which was symptomatic, one hallux varus, and three neuromas of the deep peroneal nerve. The range of motion of the hallux metatarsophalangeal joint was 85% of normal postoperatively. A total of 77% of the patients were totally relieved, 15% partially relieved, and 8% not relieved with respect to pain, comfort, appearance of the foot, and shoewear following surgery. The specific indications for performing this operation are discussed.
对41名女性和12名男性的第一跖楔关节进行了67例闭合楔形关节融合术。平均随访28个月（范围16 - 49个月），53例患者中的51例接受了随访，随访方式包括问卷调查、临床检查以及术前和术后负重X线片对比。术前拇外翻平均角度为34.5度（范围20度 - 75度），术后矫正至13.0度（范围 - 10度 - 22度）。术前第一、二跖骨间平均夹角为14.3度（范围9.5度 - 34度），术后平均矫正至5.8度（范围0度 - 12度）。并发症包括7例浅表针道感染、3例有症状的背侧拇囊炎，其中1例需再次手术、7例不愈合，其中1例有症状、1例拇内翻以及3例腓深神经神经瘤。术后拇趾跖趾关节活动度为正常的85%。术后，77%的患者在疼痛、舒适度、足部外观和鞋类穿着方面完全缓解，15%部分缓解，8%未缓解。文中讨论了进行该手术的具体指征。
