Basile Attilio, Albo Francesco, Via Alessio Giai
Department of Orthopaedics and Traumatology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
Departmento of Orthopaedics and Traumatology, Ospedale Padre Pio, Bracciano, Italy.
J Foot Ankle Surg. 2015 Sep-Oct;54(5):910-6. doi: 10.1053/j.jfas.2015.04.004. Epub 2015 May 28.
Hammertoe is one of the most common foot deformities. Arthrodesis or arthroplasty of the proximal interphalangeal joint using temporary Kirschner wire fixation is the most widespread method of surgical stabilization. However, this type of fixation is associated with some potential complications that can be obviated if percutaneous fixation is avoided. The purpose of the present study was to prospectively collect clinical and radiographic outcomes of operative correction of hammertoe deformity using a permanently implanted 1-piece intramedullary device. A total of 29 patients with 60 painful, rigid hammertoes were prospectively enrolled, clinically and radiographically examined, operatively treated, then followed and re-examined. The outcomes were measured in terms of the American Orthopaedic Foot and Ankle Society lesser toe and visual analog pain scores. After ≥18 months of follow-up, the incidence of fusion with satisfactory radiographic alignment was 85% (51 of 60 toes). One toe (1.67%) developed early postoperative implant failure because of dislocation of the device, there were no cases of infection, and the mean American Orthopaedic Foot and Ankle Society lesser toe score was 87.4 ± 1.3 and the mean visual analog scale pain score was 1.78 ± 0.94. Twenty-five patients (86.21%) stated that they had no symptoms in the involved toes after surgery, and 4 (13.8%) experienced occasional pain, 2 (6.9%) of whom reported limitations of recreational activities and 2 (6.9%) reported persistent swelling without activity limitations. All the patients stated that they would undergo the surgery again if they had the same preoperative condition.
槌状趾是最常见的足部畸形之一。使用临时克氏针固定进行近侧指间关节融合术或关节成形术是最广泛应用的手术稳定方法。然而,这种固定方式存在一些潜在并发症,如果避免经皮固定则可以消除这些并发症。本研究的目的是前瞻性收集使用永久性植入的一体式髓内装置手术矫正槌状趾畸形的临床和影像学结果。总共前瞻性纳入了29例患有60个疼痛、僵硬槌状趾的患者,进行了临床和影像学检查、手术治疗,然后进行随访和复查。结果根据美国矫形足踝协会小趾评分和视觉模拟疼痛评分进行测量。随访≥18个月后,影像学对线满意的融合发生率为85%(60个趾中的51个)。1个趾(1.67%)因装置脱位出现术后早期植入物失败,无感染病例,美国矫形足踝协会小趾评分的平均值为87.4±1.3,视觉模拟量表疼痛评分的平均值为1.78±0.94。25例患者(86.21%)表示术后患趾无症状,4例(13.8%)偶尔疼痛,其中2例(6.9%)报告娱乐活动受限,2例(6.9%)报告持续肿胀但无活动受限。所有患者均表示,如果术前情况相同,他们愿意再次接受手术。