Kerr Hui-Ling, Jackson Rosalyn, Kothari Paresh
Orthopaedics, King's Mill Hospital, Nottinghamshire, Nottingham, UK.
J Foot Ankle Surg. 2010 Jan-Feb;49(1):16-9. doi: 10.1053/j.jfas.2009.07.024.
This study assessed the radiological measurements, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and patient satisfaction associated with performance of the scarf osteotomy, combined with an Akin osteotomy, for the treatment of hallux valgus in patients at a general hospital. Thirty-five patients were assessed before surgery, and at 6 months following performance of the scarf first metatarsal osteotomy plus Akin osteotomy. The mean first intermetatarsal and hallux abductus angles reduced from 14.1 degrees +/- 3.5 degrees to 10.0 degrees +/- 3.2 degrees and 32.1 degrees +/- 9.9 degrees to 16.4 degrees +/- 7.9 degrees , respectively, and these differences were statistically significant (P < .001). The mean first to second metatarsal sagittal plane length ratio was unchanged by the osteotomy (P > .05). The mean global AOFAS Hallux Metatarsophalangeal-Interphalangeal score increased from 58.8 +/- 11.6 to 86.4 +/- 11.6, and this difference was statistically significant (P < .0001). Of the 35 patients (36 operated feet), 20 (57.1%) were extremely satisfied, 10 (28.6%) were satisfied, and 5 (14.3%) were unsatisfied with the results of the surgery. Based on these results, we concluded that the improved radiographic angles and AOFAS scores observed in this study were comparable to previously reported results, and our findings indicated that, in the setting of a general hospital, the scarf osteotomy combined with the Akin osteotomy is a safe, versatile and useful procedure for the treatment of hallux valgus.
本研究评估了在一家综合医院中,采用叠瓦状截骨术联合Akin截骨术治疗拇外翻患者时的影像学测量结果、美国矫形足踝协会(AOFAS)评分以及患者满意度。对35例患者在手术前以及在进行叠瓦状第一跖骨截骨术加Akin截骨术后6个月进行了评估。第一跖骨间平均角和拇外展角分别从14.1°±3.5°减小至10.0°±3.2°,以及从32.1°±9.9°减小至16.4°±7.9°,这些差异具有统计学意义(P <.001)。截骨术后第一跖骨与第二跖骨矢状面长度比的平均值未发生变化(P >.05)。AOFAS拇跖趾-趾间关节平均总评分从58.8±11.6提高至86.4±11.6,这一差异具有统计学意义(P <.0001)。在这35例患者(36只手术足)中,20例(57.1%)对手术结果极为满意,10例(28.6%)满意,5例(14.3%)不满意。基于这些结果,我们得出结论,本研究中观察到的影像学角度改善和AOFAS评分与先前报道的结果相当,我们的研究结果表明, 在综合医院环境下,叠瓦状截骨术联合Akin截骨术是一种治疗拇外翻安全、通用且有效的手术方法。