Garg Rishi, Thordarson David B, Schrumpf Mark, Castaneda Deborah
Los Angeles, CA, USA.
Foot Ankle Int. 2008 Oct;29(10):1009-14. doi: 10.3113/FAI.2008.1009.
Oblique shortening osteotomy (Weil) can address lesser MP pathology but can have a high rate of complications. The purpose of this study was to review the results of a modification of the Weil osteotomy, the segmental resection metatarsal osteotomy.
Between 2004 and 2006, 48 patients underwent the segmental resection osteotomy with a mean followup of 13 (range, 6 to 26) months. All the patients were evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score and a questionnaire addressing distances they were able to walk, work limitations, sporting activity, and overall satisfaction.
The postoperative AOFAS forefoot score was an average of 87.6 (range, 59 to 100; SD, 10.97) and the overall satisfaction rate was 85.4%. The complication rate was 18.8% for transfer metatarsalgia, 27.1% for floating toes, 35.4% for toe weakness, 14.6% for infection, and 10.4% for wound healing problems.
Despite the complications, the patients who underwent segmental osteotomy were satisfied with the outcome for lesser MTP joint pain and deformity. This is a preliminary study with significant refinement of the operative method as detailed in the surgical technique section. Further followup will elucidate whether additional changes are necessary in the surgical technique.
斜行缩短截骨术（韦尔截骨术）可解决跖趾关节较少见的病变，但并发症发生率较高。本研究的目的是回顾韦尔截骨术改良术式——节段性切除跖骨截骨术的结果。
2004年至2006年期间，48例患者接受了节段性切除截骨术，平均随访13（6至26）个月。所有患者均采用美国矫形足踝协会（AOFAS）前足评分进行评估，并通过一份问卷来了解他们能够行走的距离、工作限制、体育活动及总体满意度。
术后AOFAS前足评分平均为87.6（范围59至100；标准差10.97），总体满意率为85.4%。转移性跖痛症的并发症发生率为18.8%，浮趾为27.1%，趾肌无力为35.4%，感染为14.6%，伤口愈合问题为10.4%。
尽管存在并发症，但接受节段性截骨术的患者对跖趾关节较少见疼痛和畸形的治疗结果感到满意。这是一项初步研究，手术方法有显著改进，详见手术技术部分。进一步随访将阐明手术技术是否需要进一步改进。
