Bauer Thomas
Department of Orthopedic Surgery, Ambroise Paré University Hospital, West Paris University, 9 avenue Charles de Gaulle, 92100 Boulogne Billancourt, France.
Open Orthop J. 2017 Jul 31;11:724-731. doi: 10.2174/1874325001711010724. eCollection 2017.
The first metatarsophalangeal (MTP1) joint fusion is a very useful procedure in forefoot surgery and is still the gold standard for the treatment of severe and painful hallux rigidus. Normal walking and running are possible after MTP1 fusion, the first ray mobility being essentially in the interphalangeal (IP) joint with a compensatory hypermobility in dorsal flexion. Percutaneous MTP1 fusion is a simple procedure providing comparable results to fusions performed with open techniques. Postoperative cares are simplified with an immediate full weight bearing on rigid flat shoes and quick return to normal walking. Bone preparation is an important step and requires an experience in percutaneous forefoot surgery. Arthrodesis positioning and fixation with this percutaneous procedure are simple with possibility of clinical and radiological control. The indications for percutaneous MTP1 fusion are very large and only severe bone loss or osteoporosis represent the limits for this technique.
第一跖趾关节(MTP1)融合术是前足手术中一项非常有用的术式,至今仍是治疗重度疼痛性僵硬拇趾的金标准。MTP1融合术后可实现正常行走和跑步,第一跖骨的活动主要通过趾间关节(IP)进行,背屈时会有代偿性的活动过度。经皮MTP1融合术操作简单,其效果与开放技术实施的融合术相当。术后护理得到简化,患者术后可立即穿着硬底平跟鞋完全负重行走,并能很快恢复正常行走。骨质准备是一个重要步骤,需要有经皮前足手术的经验。采用这种经皮手术进行关节固定术的定位和固定都很简单,还能进行临床和影像学检查。经皮MTP1融合术的适应证范围很广,只有严重的骨质流失或骨质疏松是该技术的限制因素。