Scharer Brandon M, DeVries J George
Surgeon, Orthopedics and Sports Medicine, BayCare Clinic, Green Bay, WI.
Surgeon, Orthopedics and Sports Medicine, BayCare Clinic, Green Bay, WI.
J Foot Ankle Surg. 2016 Jul-Aug;55(4):738-42. doi: 10.1053/j.jfas.2016.01.036. Epub 2016 Mar 10.
The chevron osteotomy is a standard procedure by which bunions are corrected. One of us routinely performs a distal oblique osteotomy, which, to the best of our knowledge, has not been described for the correction of bunion deformities. The purpose of the present study was to compare the short- and medium-term results of the distal oblique and chevron osteotomies for bunion correction. We performed a retrospective clinical and radiographic comparison of patients who had undergone a distal oblique or chevron osteotomy for the correction of bunion deformity. In addition, a prospective patient satisfaction survey was undertaken. A total of 55 patients were included in the present study and were treated from January 2012 to November 2014. Of the 55 patients, 27 (49.2%) were in the chevron group and 28 (50.8%) in the distal oblique group. Radiographically, no statistically significant difference was found between the 2 groups with respect to postoperative first intermetatarsal angle (p < .0001) and hallux valgus angle (p < .0001), but a greater change was found in the intermetatarsal angle in the distal oblique group (p = .467). Prospective patient satisfaction scores were available for 33 patients (60%), 16 (29%) in the chevron group and 17 (31%) in the distal oblique group. When converting the satisfaction score to a numerical score, the chevron group scored 3.3 ± 1.1 and the distal oblique group scored 3.2 ± 0.8 (p = .812). We found that the distal oblique osteotomy used in the present study is simple and reliable and showed radiographic correction and patient satisfaction equivalent to those in the chevron osteotomy.
V形截骨术是矫正拇外翻的标准术式。我们中的一人常规进行远端斜形截骨术，据我们所知，尚未有文献描述该术式用于矫正拇外翻畸形。本研究的目的是比较远端斜形截骨术和V形截骨术矫正拇外翻的短期和中期效果。我们对接受远端斜形或V形截骨术矫正拇外翻畸形的患者进行了回顾性临床和影像学比较。此外，还进行了一项前瞻性患者满意度调查。本研究共纳入55例患者，治疗时间为2012年1月至2014年11月。55例患者中，27例（49.2%）在V形截骨组，28例（50.8%）在远端斜形截骨组。影像学检查显示，两组术后第一跖骨间角（p<0.0001）和拇外翻角（p<0.0001）差异无统计学意义，但远端斜形截骨组的跖骨间角变化更大（p=0.467）。33例患者（60%）有前瞻性患者满意度评分，V形截骨组16例（29%），远端斜形截骨组17例（31%）。将满意度评分转换为数值评分时，V形截骨组评分为3.3±1.1，远端斜形截骨组评分为3.2±0.8（p=0.812）。我们发现，本研究中使用的远端斜形截骨术简单可靠，在影像学矫正和患者满意度方面与V形截骨术相当。
