Department of Orthopaedics and Traumatology, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675 München, Germany.
Foot Ankle Surg. 2010 Mar;16(1):9-14. doi: 10.1016/j.fas.2009.03.003. Epub 2009 May 15.
The intention of this study was to analyze the long-term results of the proximal closing wedge osteotomy for the correction of hallux valgus deformity, modified by adding a mini L-plate for osteosynthesis.
The outcome of a proximal first metatarsal closing wedge osteotomy was retrospectively evaluated after a mean follow-up of 52 months. A total of 66 female patients (86 feet) participated in this study. The AOFAS-score was used to evaluate the postoperative results. Pre- and postoperative weight-bearing radiographs were used to evaluate the osseous development.
95.5% of the patients were satisfied, 3 patients (4.5%) were not satisfied with the overall result of the operation. Transfer metatarsalgia was registered in 7 of 50 cases. The mean improvement of the HV-angle was 22.1 degrees (36.4 degrees to 14.3 degrees ) and the intermetatarsal angle was reduced from a mean of 17.6 degrees to a mean of 6.5 degrees . The mean first metatarsal shortening was 3.2mm. The mean AOFAS-score was 78 points.
The results confirm, that the closing wedge osteotomy is indicated for moderate to severe hallux valgus. The shortening of the first ray is comparable with other well-established operative procedures. The risk of transfer metatarsalgia can only be lightly reduced by this procedure.
本研究旨在分析改良近端闭合楔形截骨术治疗拇外翻畸形的长期疗效，改良方法是在骨愈合中加入微型 L 板。
平均随访 52 个月后，回顾性评估第一跖骨近端闭合楔形截骨术的结果。共有 66 名女性患者（86 只脚）参与了这项研究。采用 AOFAS 评分评估术后结果。术前和术后负重位 X 线片用于评估骨发育情况。
95.5%的患者满意，3 名（4.5%）患者对手术整体结果不满意。50 例中有 7 例出现转移性跖骨痛。HV 角的平均改善为 22.1 度（36.4 度至 14.3 度），中间跖骨角从平均 17.6 度减少至平均 6.5 度。第一跖骨平均缩短 3.2mm。平均 AOFAS 评分为 78 分。
研究结果证实，闭合楔形截骨术适用于中重度拇外翻。第一跖骨缩短与其他成熟的手术方法相当。通过这种手术方法，转移性跖骨痛的风险只能轻微降低。
