Wagner Emilio, Ortiz Cristian
Clinica Alemana, Departamento de Traumatologia y Ortopedia, Vitacura, Santiago, Chile.
Foot Ankle Clin. 2012 Sep;17(3):481-98. doi: 10.1016/j.fcl.2012.06.007. Epub 2012 Aug 9.
Efforts are currently being made to improve results in hallux valgus treatment. Different studies to design procedures that are more stable and efficient to correct deformities are underway, and new techniques will be presented in the following years. Better fixation devices will offer reliability in corrections, and hopefully will allow faster rehabilitation with fewer restrictions. Understanding the concept of correction power is important when deciding which technique to use. The origin of hallux valgus is not known, but evidence exists to assume that a correct skeletal and soft tissue balance is important to prevent recurrence and obtain good function. We think that a correct metatarsophalangeal reduction, in which the final position of the hallux is defined mainly by the skeletal alignment and not soft tissues, will dictate the final result. Pushing the metatarsal bone over the sesamoids and not moving the sesamoids under the metatarsal head is a new concept and it may allow better results for our patients. It is hoped that understanding of biomechanics will continue to evolve, and radiological measurements and corrections will produce better functional results for patients.
目前正在努力改善拇外翻治疗的效果。正在进行不同的研究以设计出更稳定、更有效的矫正畸形的手术方法，未来几年将推出新技术。更好的固定装置将为矫正提供可靠性，并有望实现更快的康复且限制更少。在决定使用哪种技术时，理解矫正力的概念很重要。拇外翻的病因尚不清楚，但有证据表明，正确的骨骼和软组织平衡对于预防复发和获得良好功能很重要。我们认为，正确的跖趾关节复位，其中拇趾的最终位置主要由骨骼排列而非软组织决定，将决定最终结果。将跖骨推过籽骨而不是将籽骨移到跖骨头下方是一个新概念，这可能会为我们的患者带来更好的结果。希望对生物力学的理解将不断发展，放射学测量和矫正将为患者带来更好的功能结果。
