Xu Can, Li Mingqing, Wang Chenggong, Liu Hua
J Am Podiatr Med Assoc. 2019 Jul;109(4):266-271. doi: 10.7547/17-115. Epub 2017 Oct 23.
Capsulorrhaphy restricts the motion of the first metatarsophalangeal joint (MTPJ) in hallux valgus surgery. However, changes in motion of the first MTPJ immediately after surgery that resulted from different capsulorrhaphy methods have not been compared. The primary aim of this study was to compare the immediate effect of Y-shaped and inverted L capsulorrhaphy methods on the range of motion (ROM) of the first MTPJ.
Y-shaped and inverted L capsulorrhaphies were performed on 16 human cadaveric feet. Passive dorsiflexion and plantarflexion of the first MTPJ were then compared preoperatively and postoperatively.
In this cadaveric study, the inverted L capsulorrhaphy method led to a ROM loss in the first MTPJ; the joint stiffness from the Y-shaped capsulorrhaphy is significantly less than that from the inverted L capsulorrhaphy.
The inverted L capsulorrhaphy may lead to a ROM loss in the first MTPJ immediately after surgery. We recommend that surgeons close the capsule of the first MTPJ with a Y-shaped capsulorrhaphy, which is less likely to result in a ROM loss in the first MTPJ in the early postoperative period.
在拇外翻手术中,关节囊缝合术会限制第一跖趾关节(MTPJ)的活动。然而,尚未比较不同关节囊缝合方法术后第一跖趾关节活动的即刻变化。本研究的主要目的是比较Y形和倒L形关节囊缝合方法对第一跖趾关节活动范围(ROM)的即刻影响。
对16只人尸体足进行Y形和倒L形关节囊缝合术。然后比较第一跖趾关节术前和术后的被动背屈和跖屈情况。
在本尸体研究中,倒L形关节囊缝合方法导致第一跖趾关节活动范围减小;Y形关节囊缝合术导致的关节僵硬程度明显低于倒L形关节囊缝合术。
倒L形关节囊缝合术可能在术后即刻导致第一跖趾关节活动范围减小。我们建议外科医生采用Y形关节囊缝合术来闭合第一跖趾关节囊,这样在术后早期第一跖趾关节活动范围减小的可能性较小。