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内镜辅助拇外翻矫正术可提供可持续的长期(>10 年)疗效。

Endoscopy-Assisted Hallux Valgus Correction Provides Sustainable Long-Term >10-Year Outcomes.

机构信息

Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, Hong Kong.

Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, Hong Kong.

出版信息

Arthroscopy. 2018 Jun;34(6):1958-1963. doi: 10.1016/j.arthro.2017.12.017. Epub 2018 Feb 15.

Abstract

PURPOSE

This study aims to review the long-term efficacy of the endoscopy-assisted distal soft-tissue procedure (EDSTP) and to see whether operative correction can be maintained for >10 years.

METHODS

All hallux valgus cases undergoing EDSTP from 2000 to 2006 were recruited. Preoperative, postoperative, and 10-year follow-up x-rays were analyzed. A pain score from the preoperative and >10-year follow-up was recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) hallux score and Foot and Ankle Outcome Score (FAOS) were measured at the >10-year follow-up.

RESULTS

A total of 85 cases met the inclusion criteria with an EDSTP performed between January 2000 and December 2006 and had a follow-up of >10 years. Hallux valgus angle corrected from 25.8° to 11.2° (P < .001), 1,2 intermetatarsal angle (1,2 IMA) improved from 13.5° to 9.5° (P < .001), and the tibial sesamoid position changed from 4 to 1 (P < .001). Pain improved from preoperative 6.5/10 to 0.5/10 (P < .001). AOFAS score was 93.5/100 at >10-year follow-up, and the FAOS was good in all 5 subcategories (range, 72.6-89.3).

CONCLUSIONS

Our results show that the EDSTP has good early postoperative results that are maintained for >10 years. It provides good long-term radiological correction, in addition to lasting pain relief and great foot function, using only 5 incisions.

LEVEL OF EVIDENCE

Level IV, case series.

摘要

目的

本研究旨在回顾内镜辅助远侧软组织手术(EDSTP)的长期疗效,并观察手术矫正是否能维持>10 年。

方法

招募了 2000 年至 2006 年期间接受 EDSTP 的所有踇外翻病例。分析术前、术后和 10 年随访的 X 线片。记录术前和>10 年随访时的疼痛评分。在>10 年随访时测量美国矫形足踝协会(AOFAS)踇趾评分和足踝结局评分(FAOS)。

结果

共有 85 例符合纳入标准,行 EDSTP 治疗,随访时间>10 年。踇外翻角从 25.8°矫正至 11.2°(P<.001),1,2 跖骨间角(1,2 IMA)从 13.5°改善至 9.5°(P<.001),胫骨籽骨位置从 4 改变至 1(P<.001)。疼痛从术前的 6.5/10 改善至 0.5/10(P<.001)。>10 年随访时 AOFAS 评分为 93.5/100,FAOS 在所有 5 个亚类中均为良好(范围为 72.6-89.3)。

结论

我们的结果表明,EDSTP 具有良好的早期术后效果,可维持>10 年。它仅通过 5 个切口即可提供良好的长期放射学矫正,同时持久缓解疼痛,改善足部功能。

证据等级

IV 级,病例系列。

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