Lorei Timo J, Kinast Christian, Klärner Hans, Rosenbaum Dieter
Movement Analysis Lab, Orthopaedic Department, University Hospital Münster, Germany.
Clin Orthop Relat Res. 2006 Oct;451:161-6. doi: 10.1097/01.blo.0000229297.29345.09.
The aim of this study was to investigate whether a Scarf osteotomy for hallux valgus correction achieves a good functional restoration with pain reduction, improved mobility, and hallux loading. Therefore, we prospectively studied 32 patients who had a Scarf osteotomy for unilateral hallux valgus. We performed clinical, radiographic, and pedographic evaluations after a mean followup of 33 months to assess clinical and functional outcomes. The mean postoperative American Orthopaedic Foot and Ankle Society score was 89 points. The hallux valgus angle improved from 32.5 degrees to 6.2 degrees , and the intermetatarsal angle improved from 15.5 degrees to 6.6 degrees . The postoperative pedographic patterns showed that the maximum force and impulse decreased under the lateral forefoot and increased under the medial forefoot and hallux. The first ray became more important in the roll-over process. There was a moderate relationship between satisfaction and postoperative hallux valgus angle. The Scarf osteotomy improved the pain situation, the walking capacity, and led to an improved contribution of the hallux in the roll-over process. Therefore, this surgical procedure restores forefoot function and normalizes plantar pressure patterns.
本研究的目的是调查用于矫正拇外翻的Scarf截骨术是否能实现良好的功能恢复，包括减轻疼痛、改善活动能力以及拇趾负重。因此，我们前瞻性地研究了32例行Scarf截骨术治疗单侧拇外翻的患者。在平均随访33个月后，我们进行了临床、影像学和足印学评估，以评估临床和功能结果。术后美国矫形足踝协会平均评分为89分。拇外翻角从32.5度改善至6.2度，跖间角从15.5度改善至6.6度。术后足印学模式显示，前足外侧的最大力和冲量减小，前足内侧和拇趾下的最大力和冲量增加。在步态转换过程中，第一跖骨变得更为重要。满意度与术后拇外翻角之间存在中等程度的相关性。Scarf截骨术改善了疼痛状况、行走能力，并使拇趾在步态转换过程中的作用得到改善。因此，该手术恢复了前足功能并使足底压力模式正常化。
