Department of Orthopedics, Chonnam Natinal University Medical School and Hospital, Donggu, Gwangju, Korea.
Foot Ankle Int. 2012 Aug;33(8):637-43. doi: 10.3113/FAI.2012.0637.
Proximal chevron osteotomy with a distal soft tissue procedure has been widely used to treat moderate to severe hallux valgus deformities. However, there have been no studies comparing the results of proximal chevron osteotomy between patients with moderate and severe hallux valgus. We compared the results of this procedure among these groups.
A retrospective review of 95 patients (108 feet) that underwent proximal chevron osteotomy and distal soft tissue procedure for moderate and severe hallux valgus was conducted. The 108 feet were divided into two groups: moderate hallux valgus (Group A) and severe hallux valgus (Group B). Group A was composed of 57 feet (52 patients) and Group B of 51 feet (43 patients). Average followup was 45 months.
Mean American Orthopedic Foot and Ankle Society hallux metatarsophalangeal-interphalangeal scores were 54.1 points in Group A and 53.0 points in Group B preoperatively, and these improved to 90.8 and 92.6, respectively, at the last followup. Mean hallux valgus angles in Groups A and B reduced from 32.3 and 40.8 degrees, preoperatively to 10.7 and 13.2 degrees, postoperatively. Similarly, mean first intermetatarsal angles in Groups A and B reduced from 15.0 and 19.2 degrees, preoperatively to 9.0 and 9.2 degrees, postoperatively.
The clinical and radiographic outcomes of proximal chevron osteotomy with a distal soft tissue procedure were found to be comparable for moderate and severe hallux valgus. Accordingly, our results suggest that this procedure provides an effective and reliable means of correcting hallux valgus regardless of severity of deformity.
近端楔形截骨术联合远端软组织松解术已广泛应用于中重度拇外翻畸形的治疗。然而，目前还没有研究比较中重度拇外翻患者近端楔形截骨术的结果。我们比较了这些患者的治疗结果。
回顾性分析了 95 例（108 足）中重度拇外翻患者行近端楔形截骨术联合远端软组织松解术的病例。108 足分为两组：中度拇外翻（A 组）和重度拇外翻（B 组）。A 组 57 足（52 例），B 组 51 足（43 例）。平均随访时间为 45 个月。
A 组术前美国矫形足踝协会拇趾-跖骨-趾间关节评分平均为 54.1 分，B 组为 53.0 分，末次随访时分别提高至 90.8 分和 92.6 分。A、B 两组拇外翻角由术前的 32.3°和 40.8°分别减少至术后的 10.7°和 13.2°，第一跖骨间角由术前的 15.0°和 19.2°分别减少至术后的 9.0°和 9.2°。
近端楔形截骨术联合远端软组织松解术治疗中重度拇外翻的临床和影像学结果相当。因此，我们的结果表明，无论畸形严重程度如何，该术式都是一种有效可靠的矫正拇外翻的方法。
