Thangarajah Tanujan, Ahmed Usman, Malik Shahbaz, Tillu Abhay
Sandwell General Hospital , Lyndon, West Bromwich, West Midlands, UK.
Orthop Rev (Pavia). 2013 Nov 27;5(4):e37. doi: 10.4081/or.2013.e37. eCollection 2013.
Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy. A retrospective review of 23 patients with moderate-severe hallux valgus treated by Mau osteotomy was conducted. Patients were assessed clinically by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system and radiologically by measuring the first intermetatarsal (IM) and hallux abductovalgus angles (HAV). The mean AOFAS score had improved from 47 preoperatively to 92 postoperatively (P<0.01). Additionally, preoperative HAV and IM angles improved from 39(o) and 15(o) respectively to 15(o) and 9(o) respectively (P<0.01). There were no cases of undercorrection or non-union. In this series, the Mau osteotomy was able to achieve good correction of the IM and HAV angles in patients with moderate-severe hallux valgus. This was reflected in a significantly higher postoperative AOFAS score. Contrary to other studies there were no cases of undercorrection and despite allowing patients to fully weight-bear postoperatively there were no cases of non-union.
拇外翻是足部最常见的病症之一,据报道几乎影响了一半的成年人口。最有效的治疗方法是进行矫正截骨术,这种手术有许多亚型。Mau截骨术能提供最大的结构稳定性,但被认为无法充分矫正中重度畸形。因此,诸如矫正不足和骨不连等并发症很常见。本研究的目的是确定中重度拇外翻患者接受Mau截骨术后的功能结果。对23例接受Mau截骨术治疗的中重度拇外翻患者进行了回顾性研究。通过美国矫形足踝协会(AOFAS)评分系统对患者进行临床评估,并通过测量第一跖骨间(IM)角和拇外翻角(HAV)进行影像学评估。AOFAS平均评分从术前的47分提高到术后的92分(P<0.01)。此外,术前HAV角和IM角分别从39°和15°改善到15°和9°(P<0.01)。没有矫正不足或骨不连的病例。在本系列研究中,Mau截骨术能够在中重度拇外翻患者中实现对IM角和HAV角的良好矫正。这反映在术后AOFAS评分显著更高。与其他研究相反,没有矫正不足的病例,并且尽管允许患者术后完全负重,但没有骨不连的病例。