Mueller Claire Mackenzie, Boden Stephanie Ann, Boden Allison Lee, Maidman Samuel David, Cutler Anya, Mignemi Danielle, Bariteau Jason
1 Emory University School of Medicine, Atlanta, GA, USA.
2 Rollins School of Public Health, Atlanta, GA, USA.
Foot Ankle Int. 2018 Jun;39(6):681-688. doi: 10.1177/1071100718755472. Epub 2018 Feb 15.
Hammertoe deformities are the most common lesser toe deformity. To date, no studies have looked at outcomes of operative management in the geriatric population, which may be at greater risk for complications or functional compromise because of comorbidities.
Data on 58 patients undergoing operative correction of hammertoe deformities were prospectively collected. Clinical outcomes were assessed using preoperative and postoperative visual analogue scale (VAS) and Short Form Health Survey (SF-36) scores with a minimum of 6-month follow-up. Patients were divided into 2 groups on the basis of age at the time of surgery: younger than 65 and 65 and older. Complication rates and mean VAS and SF-36 improvement were compared. Forty-seven patients met inclusion criteria (7 men, 40 women), with 26 patients (37 toes) in the younger cohort and 21 patients (39 toes) in the older cohort.
Overall, patients demonstrated significant improvement from baseline to 6 and 12 months postoperatively in VAS ( P < .001 and P < .001) and SF-36 ( P < .001 and P < .001) scores. Mean improvement in VAS and SF-36 scores was not significantly different between the groups at 6 and 12 months postoperatively. Complications occurred in 13.5% and 10.3% of patients in the younger and older cohorts, respectively.
Outcomes of operative correction of hammertoe deformities in older patients were similar to outcomes in younger patients after greater than 6 months of follow-up. Overall improvement in VAS and SF-36 was statistically significant for both cohorts. There was no associated increase in complications for older patients.
Level, III comparative series.
槌状趾畸形是最常见的小趾畸形。迄今为止,尚无研究关注老年人群手术治疗的结果,由于合并症,这一人群可能发生并发症或功能受损的风险更高。
前瞻性收集58例行槌状趾畸形手术矫正患者的数据。采用术前和术后视觉模拟量表(VAS)及简短健康调查问卷(SF-36)评分评估临床结果,随访时间至少6个月。根据手术时的年龄将患者分为两组:65岁以下和65岁及以上。比较并发症发生率以及VAS和SF-36的平均改善情况。47例患者符合纳入标准(7例男性,40例女性),年轻队列中有26例患者(37趾),老年队列中有21例患者(39趾)。
总体而言,患者术后6个月和12个月时VAS评分(P <.001和P <.001)及SF-36评分(P <.001和P <.001)较基线均有显著改善。术后6个月和12个月时,两组患者VAS和SF-36评分的平均改善情况无显著差异。年轻队列和老年队列中分别有13.5%和10.3%的患者发生并发症。
老年患者槌状趾畸形手术矫正的结果与年轻患者随访6个月以上的结果相似。两组患者VAS和SF-36的总体改善在统计学上均有显著意义。老年患者并发症未随之增加。
III级比较系列。