Yeo Nicholas Eng Meng, Loh Bryan, Chen Jerry YongQiang, Yew Andy Khye Soon, Ng Sean Yc
Department of Orthopaedic Surgery, Singapore General Hosptial, Singapore.
J Orthop Surg (Hong Kong). 2016 Dec;24(3):350-353. doi: 10.1177/1602400315.
To compare the 6-month outcome of Weil osteotomy with distal metatarsal mini-invasive osteotomy (DMMO) in 33 patients with lesser toe metatarsalgia.
Records of 33 patients who underwent Weil osteotomy (n=20, 41 toes) or DMMO (n=13, 22 toes) for lesser toe metatarsalgia by a single surgeon were reviewed. 25 of them had a concurrent procedure on the 1st toe. Outcome at 6 months was assessed using the visual analogue score (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) lesser toe metatarsophalangeal-interphalangeal (MTP-IP) score, and the RAND-36 score.
The 2 groups were comparable in terms of age, gender, and preoperative MTP joint range of motion (ROM), VAS for pain, AOFAS lesser toe MTPIP score, and RAND-36 scores. At 6 months, the Weil osteotomy group had a higher RAND-36 (mental) score (92 vs. 78, p=0.026), and the DMMO group had a higher percentage of toes with greater MTP joint ROM (p=0.043). All patients achieved bone union within 6 months. Two patients in the DMMO group had prolonged oedema until 3 months post-surgery.
DMMO is a safe and reliable alternative to Weil osteotomy for metatarsalgia and can preserve ROM of the MTP joints.
比较33例小趾跖痛症患者接受Weil截骨术与跖骨远端微创截骨术（DMMO）的6个月疗效。
回顾了由一名外科医生为小趾跖痛症患者实施Weil截骨术（n = 20，41趾）或DMMO（n = 13，22趾）的33例患者的记录。其中25例患者同时对第一趾进行了手术。使用疼痛视觉模拟评分（VAS）、美国矫形足踝协会（AOFAS）小趾跖趾关节-趾间关节（MTP-IP）评分和RAND-36评分评估6个月时的疗效。
两组在年龄、性别、术前MTP关节活动范围（ROM）、疼痛VAS、AOFAS小趾MTP-IP评分和RAND-36评分方面具有可比性。6个月时，Weil截骨术组的RAND-36（心理）评分更高（92 vs. 78，p = 0.026），DMMO组MTP关节ROM更大的趾的百分比更高（p = 0.043）。所有患者均在6个月内实现骨愈合。DMMO组有2例患者术后3个月仍有持续性水肿。
对于跖痛症，DMMO是Weil截骨术的一种安全可靠的替代方法，并且可以保留MTP关节的活动度。
