Cho Byung-Ki, Park Ji-Kang, Choi Seung-Myung, SooHoo Nelson F
Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, South Korea.
Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, South Korea.
Foot Ankle Surg. 2019 Apr;25(2):127-131. doi: 10.1016/j.fas.2017.09.006. Epub 2017 Oct 13.
This study was performed to evaluate the intermediate-term clinical outcomes after proximal chevron osteotomy for hallux valgus in patients with generalized ligamentous laxity, and to determine the effect on postoperative recurrence of deformity.
There were 23 cases in laxity group (Beighton score ≥5 points) and 175 in non-laxity group with a mean followup of 46.3 months. Clinical evaluation consisted of the AOFAS score, Foot and Ankle Ability Measure (FAAM), and radiographic measurement of hallux alignment. Risk factors associated with postoperative recurrence were evaluated using univariate analysis.
Recurrence rates were 21.7% in the laxity group and 17.1% in non-laxity group (P=.218). There were no significant differences in clinical and radiographic measurements at final followup between the 2 groups. Preoperative HVA and IMA were found to be predictive factors of recurrence (OR=6.3, 4.2; P=.001, .018, respectively).
There were no statistical differences in the clinical and radiographic outcomes between hallux valgus with and without generalized ligamentous laxity. Generalized ligamentous laxity demonstrated no definitive effects on postoperative recurrence of hallux valgus deformity.
本研究旨在评估患有全身性韧带松弛的拇外翻患者行近端V形截骨术后的中期临床疗效，并确定其对术后畸形复发的影响。
韧带松弛组有23例（Beighton评分≥5分），非韧带松弛组有175例，平均随访46.3个月。临床评估包括美国足踝外科协会（AOFAS）评分、足踝能力测量（FAAM）以及拇趾对线的影像学测量。采用单因素分析评估与术后复发相关的危险因素。
韧带松弛组的复发率为21.7%，非韧带松弛组为17.1%（P = 0.218）。两组末次随访时的临床和影像学测量结果无显著差异。术前的拇外翻角（HVA）和第1、2跖骨间角（IMA）被发现是复发的预测因素（OR分别为6.3、4.2；P分别为0.001、0.018）。
伴有和不伴有全身性韧带松弛的拇外翻患者在临床和影像学结果方面无统计学差异。全身性韧带松弛对拇外翻畸形术后复发无明确影响。
