克莱默截骨术治疗小趾囊炎畸形的临床和影像学结果。
Clinical and radiographic outcomes of the Kramer osteotomy in the treatment of bunionette deformity.
作者信息
Lee David C, de Cesar Netto Cesar, Staggers Jackson Rucker, Siegel Rebecca, Chen Richard, Bae Su-Young, Schon Lew C
机构信息
Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, United States; Department of Orthopedic Surgery, Harbor-UCLA Medical Center, Torrance, CA, United States.
Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, United States; Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, United States.
出版信息
Foot Ankle Surg. 2018 Dec;24(6):530-534. doi: 10.1016/j.fas.2017.07.004. Epub 2017 Jul 18.
BACKGROUND
Bunionette deformity is a painful bony prominence of the 5th metatarsal. We evaluated outcomes of using a Kramer osteotomy to treat this condition.
METHODS
Retrospective study of patients treated with a Kramer osteotomy from 2003 and 2016. Outcome measures included Foot Functional Index (FFI) and radiographic measurements.
RESULTS
38 patients (43 feet) with an average follow-up of 55 months. Mean postoperative FFI was 19.4. Mean 4-5 IMA improved 3.9°, from 8.3° preoperatively to 4.4° on final postoperative films (p<0.01). Mean MTP-5 angle improved 13.2° from 13.6° preoperatively to 0.4° at final follow-up (p<0.01). There were 5 delayed unions (11.6%) and 1 non-union (2.3%).
CONCLUSIONS
The Kramer osteotomy is an effective treatment option in patients with bunionette deformity, with significant correction of the 4-5 IM and MTP-5 angles and few complications.
背景
小趾囊炎畸形是第五跖骨的疼痛性骨突出。我们评估了使用克莱默截骨术治疗这种疾病的效果。
方法
对2003年至2016年接受克莱默截骨术治疗的患者进行回顾性研究。结果指标包括足部功能指数（FFI）和影像学测量。
结果
38例患者（43只脚），平均随访55个月。术后平均FFI为19.4。平均4-5跖骨间角改善了3.9°，从术前的8.3°改善至术后最终X线片上的4.4°（p<0.01）。平均第5跖趾关节角从术前的13.6°改善了13.2°，在最终随访时为0.4°（p<0.01）。有5例延迟愈合（11.6%）和1例不愈合（2.3%）。
结论
克莱默截骨术是治疗小趾囊炎畸形患者的一种有效治疗选择，可显著矫正4-5跖骨间角和第5跖趾关节角，且并发症较少。
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