Lee David C, de Cesar Netto Cesar, Staggers Jackson Rucker, Siegel Rebecca, Chen Richard, Bae Su-Young, Schon Lew C
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.
Foot Ankle Surg. 2018 Dec;24(6):530-534. doi: 10.1016/j.fas.2017.07.004. Epub 2017 Jul 18.
Bunionette deformity is a painful bony prominence of the 5th metatarsal. We evaluated outcomes of using a Kramer osteotomy to treat this condition.
Retrospective study of patients treated with a Kramer osteotomy from 2003 and 2016. Outcome measures included Foot Functional Index (FFI) and radiographic measurements.
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%).
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.
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。
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。
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%）。
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。
