Mahadevan Devendra, Lines Stephen, Hepple Stephen, Winson Ian, Harries William
Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, UK.
Foot Ankle Surg. 2016 Jun;22(2):109-13. doi: 10.1016/j.fas.2015.05.012. Epub 2015 Jun 8.
The purpose of this RCT was to compare the extended plantar limb (modified) chevron osteotomy with the scarf osteotomy in correcting hallux valgus deformity and improving functional scores and patient satisfaction.
Patients were randomly assigned and kept blind to surgical allocation. Cases requiring additional procedures including the Akin osteotomy were excluded. Outcomes were measured at 1 year following surgery.
84 patients (109 feet) were analysed (60 modified chevron; 49 Scarf). The mean age was 50.7 years (75F: 9M). Post-operative intermetatarsal angle (IMA) was significantly lower in the modified chevron group (5.8° versus 6.9°, p=0.045). Hallux valgus angle and distal metatarsal articular angle were similar. The magnitude of IMA correction with the modified chevron was also significantly greater (9.1° versus 7.1°, p=0.007). Both osteotomies produced comparable MOxFQ scores and satisfaction ratings.
The modified chevron was superior to the scarf osteotomy in correcting IMA in hallux valgus deformity.
本随机对照试验的目的是比较延长跖侧肢体（改良）V形截骨术与围巾式截骨术在矫正拇外翻畸形、改善功能评分和患者满意度方面的效果。
患者被随机分组，对手术分配情况不知情。排除需要包括Akin截骨术等额外手术的病例。在术后1年测量结果。
分析了84例患者（109只脚）（60例行改良V形截骨术；49例行围巾式截骨术）。平均年龄为50.7岁（75名女性：9名男性）。改良V形截骨术组术后跖间角（IMA）显著更低（5.8°对6.9°，p = 0.045）。拇外翻角和跖骨头远端关节角相似。改良V形截骨术矫正IMA的幅度也显著更大（9.1°对7.1°，p = 0.007）。两种截骨术产生的MOxFQ评分和满意度评级相当。
在矫正拇外翻畸形的IMA方面，改良V形截骨术优于围巾式截骨术。
