Chopra S, Moerenhout K, Crevoisier X
Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne (UNIL), Department of Orthopaedic Surgery and Traumatology, Pierre-Decker 4, CH-1011 Lausanne, Switzerland.
Clin Biomech (Bristol). 2016 Feb;32:187-93. doi: 10.1016/j.clinbiomech.2015.11.012. Epub 2015 Dec 7.
Studies have assessed the outcome of hallux valgus surgeries based on subjective questionnaires, usually the American Orthopaedic Foot and Ankle Society Score, and radiographic results reporting good to excellent outcome at 6-12 months postoperatively. However, contrasting results were reported by gait studies at 12-24 months postoperatively. In a previous study, we found nine gait parameters which can describe the altered gait in hallux valgus deformity. This study aimed, to assess the outcome of modified Lapidus at 6 months postoperatively, using gait assessment method, to determine if the nine specified gait parameters effectively relates with the clinical scores and the radiological results or add information missed by these commonly used clinical assessments.
We assessed 21 participants including 11 controls and 10 patients with moderate to severe hallux valgus deformity. The patient group was followed 6 months postoperatively. The ambulatory gait assessment was performed utilizing pressure insoles and inertial sensors. Clinical assessment includes foot and ankle questionnaires along with radiographic results. Comparison was made using non parametric tests, P<0.05.
Altered gait patterns, similar to the preoperative outcome, persisted at 6 months postoperatively when compared to controls. The foot and ankle ability measure score showed an outcome comparable to the gait results. In contrast, the American Orthopaedic Foot and Ankle Society Score and radiographic results showed significant improvement.
Study supports the reliability of nine defined gait parameters in assessing the outcome of hallux valgus surgeries. The existing clinical assessment overestimates the functional outcome at the early postoperative phase.
以往的研究基于主观问卷（通常是美国矫形足踝协会评分）以及术后6至12个月时报告良好至优秀结果的影像学结果来评估拇外翻手术的疗效。然而，术后12至24个月的步态研究报告了相反的结果。在之前的一项研究中，我们发现了九个可以描述拇外翻畸形中步态改变的参数。本研究旨在采用步态评估方法评估改良Lapidus手术后6个月的疗效，以确定这九个特定的步态参数是否与临床评分和影像学结果有效相关，或者是否能提供这些常用临床评估所遗漏的信息。
我们评估了21名参与者，其中包括11名对照组和10名患有中度至重度拇外翻畸形的患者。患者组在术后6个月进行随访。使用压力鞋垫和惯性传感器进行动态步态评估。临床评估包括足踝问卷以及影像学结果。采用非参数检验进行比较，P<0.05。
与对照组相比，术后6个月时仍存在与术前结果相似的步态模式改变。足踝能力测量评分显示的结果与步态结果相当。相比之下，美国矫形足踝协会评分和影像学结果显示有显著改善。
该研究支持了九个定义的步态参数在评估拇外翻手术疗效方面的可靠性。现有的临床评估在术后早期高估了功能结果。
