Chong A, Nazarian N, Chandrananth J, Tacey M, Shepherd D, Tran P
Western Health, Melbourne, Australia.
Northern Health, Melbourne, Australia.
Bone Joint J. 2015 Feb;97-B(2):208-14. doi: 10.1302/0301-620X.97B2.34891.
This study sought to determine the medium-term patient-reported and radiographic outcomes in patients undergoing surgery for hallux valgus. A total of 118 patients (162 feet) underwent surgery for hallux valgus between January 2008 and June 2009. The Manchester-Oxford Foot Questionnaire (MOXFQ), a validated tool for the assessment of outcome after surgery for hallux valgus, was used and patient satisfaction was sought. The medical records and radiographs were reviewed retrospectively. At a mean of 5.2 years (4.7 to 6.0) post-operatively, the median combined MOXFQ score was 7.8 (IQR:0 to 32.8). The median domain scores for pain, walking/standing, and social interaction were 10 (IQR: 0 to 45), 0 (IQR: 0 to 32.1) and 6.3 (IQR: 0 to 25) respectively. A total of 119 procedures (73.9%, in 90 patients) were reported as satisfactory but only 53 feet (32.7%, in 43 patients) were completely asymptomatic. The mean (SD) correction of hallux valgus, intermetatarsal, and distal metatarsal articular angles was 18.5° (8.8°), 5.7° (3.3°), and 16.6° (8.8°), respectively. Multivariable regression analysis identified that an American Association of Anesthesiologists grade of >1 (Incident Rate Ratio (IRR) = 1.67, p-value = 0.011) and recurrent deformity (IRR = 1.77, p-value = 0.003) were associated with significantly worse MOXFQ scores. No correlation was found between the severity of deformity, the type, or degree of surgical correction and the outcome. When using a validated outcome score for the assessment of outcome after surgery for hallux valgus, the long-term results are worse than expected when compared with the short- and mid-term outcomes, with 25.9% of patients dissatisfied at a mean follow-up of 5.2 years.
本研究旨在确定接受拇外翻手术患者的中期患者报告结局和影像学结局。2008年1月至2009年6月期间，共有118例患者（162足）接受了拇外翻手术。使用了曼彻斯特-牛津足部问卷（MOXFQ），这是一种经过验证的用于评估拇外翻手术后结局的工具，并了解患者满意度。对病历和X光片进行了回顾性分析。术后平均5.2年（4.7至6.0年），MOXFQ综合评分中位数为7.8（四分位间距：0至32.8）。疼痛、行走/站立和社交互动的领域评分中位数分别为10（四分位间距：0至45）、0（四分位间距：0至32.1）和6.3（四分位间距：0至25）。共有119例手术（90例患者中的73.9%）报告为满意，但只有53足（43例患者中的32.7%）完全无症状。拇外翻、跖间和跖骨头关节角的平均（标准差）矫正度分别为18.5°（8.8°）、5.7°（3.3°）和16.6°（8.8°）。多变量回归分析确定，美国麻醉医师协会分级>1（发生率比（IRR）=1.67，p值=0.011）和复发性畸形（IRR=1.77，p值=0.003）与MOXFQ评分显著更差相关。未发现畸形严重程度、手术矫正类型或程度与结局之间存在相关性。在使用经过验证的结局评分评估拇外翻手术后的结局时，与短期和中期结局相比，长期结果比预期更差，在平均随访5.2年时，25.9%的患者不满意。
