Crespo Romero Eusebio, Arcas Ordoño Alvaro, Peñuela Candel Raquel, Gómez Gómez Silvia, Arias Arias Angel, Gálvez González Jaime, Crespo Romero Ricardo
Orthopaedic and Traumatology Unit (ECR, AAO, RPC, SGG, JGG, RCR).
Research Support Unit (AAA).
Foot Ankle Spec. 2017 Dec;10(6):502-508. doi: 10.1177/1938640016685147. Epub 2017 Jan 9.
Many factors are considered predictors of recurrence after hallux valgus (HV) surgery, including preoperative distal metatarsal articular angle (DMAA). The restoration of the bone and joint alignment would be more important than realigning the cartilaginous surface of the metatarsal head. Therefore, is DMAA correction essential for a good clinical and radiological results after HV surgery? This study aims to illustrate the results of percutaneous forefoot surgery (PFS) for correction of HV deformity without DMAA correction.
A prospective single-center study of 74 patients (89 feet), with mild-to-moderate hallux valgus deformity, who underwent PFS. The mean latest follow-up was 57.3 months.
Preoperative median visual analog scale was 7 points and AOFAS scores were 52 points. At the mean latest follow up both scores improved to 0 points and 90 points, respectively. Median HV angle and intermetatarsal angle changed from 30° and 12° preoperatively, to 21° and 11° at mean latest follow-up. Overall, 80% of the patients were satisfied or very satisfied. Recurrence of medial first metatarsal head pain occurred in 12 cases (13.5%).
PFS, without DMAA correction, is a valid procedure for surgical correction in patients with HV, despite the slightly worse radiographic results in our study.
Level II: Prospective study.
许多因素被认为是拇外翻（HV）手术后复发的预测指标，包括术前第1跖骨头关节角（DMAA）。骨与关节对线的恢复可能比第1跖骨头软骨面的重新对线更为重要。因此，DMAA的矫正对于HV手术后良好的临床和影像学结果是否至关重要？本研究旨在阐述在不矫正DMAA的情况下，经皮前足手术（PFS）矫正HV畸形的结果。
对74例（89足）轻至中度拇外翻畸形患者进行前瞻性单中心研究，这些患者接受了PFS。平均末次随访时间为57.3个月。
术前视觉模拟评分中位数为7分，美国足与踝关节协会（AOFAS）评分为52分。在平均末次随访时，这两项评分分别改善至0分和90分。HV角和第1、2跖骨间角的中位数术前分别为30°和12°，平均末次随访时分别变为21°和11°。总体而言，80%的患者满意或非常满意。内侧第1跖骨头疼痛复发12例（13.5%）。
在不矫正DMAA的情况下，PFS对于HV患者的手术矫正是一种有效的方法，尽管在本研究中影像学结果略差。
II级：前瞻性研究。
