Department of Orthopaedic Surgery, College of Medicine, University of Cincinnati, PO Box 670212, 231 Albert Sabin Way, Cincinnati, OH 45267-0212, USA.
Foot Ankle Surg. 2012 Mar;18(1):e4-8. doi: 10.1016/j.fas.2011.08.001. Epub 2011 Dec 14.
The objective of this report is to describe three cases (four feet) of hallux valgus interphalangeus deformity in the pediatric population.
A retrospective review was completed to identify three patients (four feet) with a deformity consistent with hallux valgus interphalangeus. Patients were followed at regular intervals for a minimum of 6 months. Treatment modalities and clinical results were reviewed for all patients for this relatively rare entity in the skeletally immature population.
All patients in this report had a deformity that was not consistent with a traumatic etiology. Case number 1 had a significantly symptomatic deformity that failed conservative treatment, and eventually necessitated full surgical correction of the deformity. Symptom free unrestricted activity was obtained post-operatively, however final follow-up radiographs have demonstrated early changes consistent with arthritis. Case numbers 2 & 3 were relatively asymptomatic throughout their course of treatment, and responded well to non-operative intervention.
Based on these findings excision of the exostosis and soft-tissue realignment appears to be a reliable option for symptom relief for patients who present with a painful symptomatic hallux valgus interphalangeus deformity. However, the risk of degenerative changes following spur removal must be entertained prior to the procedure. On the contrary a pain free deformity that does not impact functionality of toe, or impair shoe ware may be treated successfully with conservative measures.
本报告的目的在于描述儿童群体中出现的三例（四只脚）跖趾关节外翻畸形病例。
对符合跖趾关节外翻畸形的三例（四只脚）患者进行回顾性研究。对所有患者的治疗方式和临床结果进行了回顾，以评估该畸形在骨骼未成熟患者中相对罕见的情况。所有患者均随访至少 6 个月。
本报告中的所有患者的畸形均不符合创伤性病因。病例 1 存在明显的症状性畸形，保守治疗失败，最终需要对畸形进行全面手术矫正。术后获得了无限制活动的自由，但最终的随访 X 线片显示早期出现关节炎改变。病例 2 和 3 在治疗过程中一直没有明显的症状，对非手术干预反应良好。
基于这些发现，对于出现疼痛性跖趾关节外翻畸形的患者，切除外生骨赘和软组织重新排列似乎是缓解症状的可靠选择。然而，在进行该手术之前，必须考虑去除骨刺后可能出现退行性改变的风险。相反，对于无痛畸形，不会影响脚趾功能或妨碍穿鞋的患者，可通过保守治疗成功治疗。
