Choi Young Rak, Lee Sang-June, Kim Jun Hyun, Kim Tae Ho, Oh Chi Hoon
Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Seong-nam, Republic of Korea.
J Orthop Surg Res. 2018 Jan 16;13(1):11. doi: 10.1186/s13018-017-0712-y.
Incomplete sesamoid reduction is a potential risk factor for the recurrence of hallux valgus. The purpose of this study was to radiologically investigate changes in sesamoid position after chevron osteotomy and the open lateral soft tissue procedure.
Sixty-eight feet that underwent operative correction for hallux valgus deformity were reviewed consecutively. The hallux valgus angle (HVA), first to second intermetatarsal angle (IMA), tibial sesamoid position (TSP), distance of the fibular sesamoid (DFS), and translation of the metatarsal head (TMH) were evaluated preoperatively and at final follow-up.
While most parameters were significantly decreased after surgery, no significant change in DFS (correction - 1.45 mm, p = 0.08) was noted. The difference between preoperative and postoperative TSP values (ΔTSP) has a moderately positive correlation with difference in TMH values (ΔTMH) (Rho 0.475, p = .000). Other parameters were similarly correlated.
First, metatarsal bone realignment reduced the sesamoid, but its position, relative to the second metatarsal axis (DFS), was unchanged. The sesamoid is reduced by the lateral translation of the first metatarsal but not by medial sesamoid migration.
籽骨复位不完全是拇外翻复发的一个潜在风险因素。本研究的目的是通过影像学研究V形截骨术和开放式外侧软组织手术后籽骨位置的变化。
连续回顾68例接受拇外翻畸形手术矫正的足部病例。术前及最终随访时评估拇外翻角（HVA）、第一与第二跖骨间角（IMA）、胫骨籽骨位置（TSP）、腓骨籽骨距离（DFS）及跖骨头平移（TMH）。
虽然术后大多数参数显著降低，但未观察到DFS有显著变化（矫正-1.45mm，p = 0.08）。术前与术后TSP值的差异（ΔTSP）与TMH值的差异（ΔTMH）呈中度正相关（Rho 0.475，p = 0.000）。其他参数也有类似的相关性。
第一，跖骨重新排列使籽骨复位，但其相对于第二跖骨轴线的位置（DFS）未改变。籽骨通过第一跖骨的外侧平移复位，而非内侧籽骨移位。
