Lee Woo-Chun, Suh Jin-Soo, Moon Jeong-Seok, Kim Ji Yeong
Inje University, Orthopaedic Surgery, 85, Jeo-dong, Jung-gu, Seoul 100-032, Republic of Korea.
Foot Ankle Int. 2009 Oct;30(10):981-5. doi: 10.3113/FAI.2009.0981.
The purpose of this study was to review our results of treatment for brachymetatarsia involving the first and fourth ray.
This study includes 47 feet of 30 patients who have been treated for brachymetatarsia of the first and fourth rays. The average age of patients was 26.4 (range, 20 to 36) years. The second and third metatarsals were shortened in 44 feet. In 41 feet, the fourth metatarsals were lengthened at one stage with resected bones from the second and third metatarsals. The lengthening or shortening of each metatarsal was recorded. American Orthopaedic Foot and Ankle Society score and subjective satisfaction were obtained for the clinical evaluation.
The average amount of shortening in the second and third metatarsal was 8.9 +/- 2.8 mm and 7.2 +/- 2.6 mm respectively. The average amount of lengthening in the fourth metatarsal was 10.3 +/- 4.1 mm. Postoperative AOFAS score was 83.2 +/- 7.6. Stiffness of the fourth metatarsophalangeal joint was the most common cause of functional deficit. All except three patients were satisfied with some reservation. Additional operations were performed on eleven feet.
Most adult patients with the first and fourth ray brachymetatarsia have been subjectively satisfied with the treatment with some loss of function mostly due to stiffness of the metatarsophalangeal joints.
本研究的目的是回顾我们对涉及第一和第四跖骨的短跖骨的治疗结果。
本研究纳入了30例因第一和第四跖骨短跖骨而接受治疗的患者的47只足。患者的平均年龄为26.4岁（范围20至36岁）。44只足的第二和第三跖骨进行了缩短。在41只足中，一期使用第二和第三跖骨切除的骨头对第四跖骨进行了延长。记录每根跖骨的延长或缩短情况。通过美国矫形足踝协会评分和主观满意度进行临床评估。
第二和第三跖骨的平均缩短量分别为8.9±2.8毫米和7.2±2.6毫米。第四跖骨的平均延长量为10.3±4.1毫米。术后美国矫形足踝协会评分为83.2±7.6。第四跖趾关节僵硬是功能缺陷的最常见原因。除3例患者外，所有患者均有一定保留地表示满意。11只足进行了额外手术。
大多数患有第一和第四跖骨短跖骨的成年患者对治疗主观上感到满意，但存在一定功能丧失，主要是由于跖趾关节僵硬。
