UNIFESP-Escola Paulista de Medicina, São Paulo, SP, Brazil.
Foot Ankle Int. 2013 May;34(5):636-44. doi: 10.1177/1071100713475351. Epub 2013 Jan 30.
In an early report on this patient cohort, we concluded that a hallux valgus deformity in males is frequently hereditary in nature. An increase in the distal metatarsal articular angle (DMAA) was observed to be the major defining characteristic of hallux valgus in males. In this follow-up study, our goal was to evaluate the effectiveness of surgical treatment for this cohort of male patients.
Data from 50 feet of male patients with hallux valgus who were surgically treated by the same surgeon between 1985 and 2005 were retrospectively analyzed. The technique was algorithmically chosen according to the severity and complexity of the deformity. Thus, 10 chevron osteotomies, 9 biplanar chevron osteotomies, 12 Mitchell osteotomies, 9 scarf osteotomies, and 10 basilar first metatarsal osteotomies were performed. The average follow-up was 10 years (range, 2-20).
After analyzing the angular radiological parameters, sesamoid subluxation, and the articular congruency, most procedures proved to have achieved adequate correction of the angular deformities. When examining each of the procedures separately, 4 of the 5 procedures had similar corrective capacities; the scarf osteotomy however had decidedly inferior results. The improvement in the postoperative American Orthopaedic Foot and Ankle Society (AOFAS) score demonstrated the clinical and functional improvement.
The algorithm was based mainly upon the presence of increased DMAA and increased severity of angular deformities. We conclude that hallux valgus deformities in males were adequately corrected with the selected techniques. Greater difficulty or resistance to surgical treatment could not be detected when we contrasted our results to females. The scarf osteotomy proved to have an inferior corrective capacity compared to the other techniques used in this series.
Level III, retrospective comparative series.
在对该患者队列的早期报告中，我们得出结论，男性的拇外翻畸形通常具有遗传性。观察到远节跖骨关节角（DMAA）增加是男性拇外翻的主要特征。在这项随访研究中，我们的目标是评估对该男性患者队列进行手术治疗的效果。
回顾性分析了 1985 年至 2005 年间由同一位外科医生手术治疗的 50 例男性拇外翻患者的足部数据。根据畸形的严重程度和复杂性，采用算法选择技术。因此，进行了 10 例 Chevron 截骨术、9 例双平面 Chevron 截骨术、12 例 Mitchell 截骨术、9 例 Scarf 截骨术和 10 例基底第一跖骨截骨术。平均随访时间为 10 年（范围 2-20 年）。
在分析了角度影像学参数、籽骨半脱位和关节一致性后，大多数手术都证明能够充分纠正角度畸形。分别检查每种手术时，5 种手术中有 4 种具有相似的矫正能力；而 Scarf 截骨术的结果明显较差。术后美国矫形足踝协会（AOFAS）评分的改善表明了临床和功能的改善。
该算法主要基于 DMAA 的增加和角度畸形的严重程度。我们得出结论，选择的技术能够充分纠正男性的拇外翻畸形。与女性相比，我们没有发现手术治疗的难度或阻力更大。与本系列中使用的其他技术相比，Scarf 截骨术的矫正能力较差。
III 级，回顾性比较系列。
