Simões R, Alves C, Tavares L, Balacó I, Cardoso P Sá, Ling T Pu, Matos G
Department of Paediatric Orthopaedics, Hospital Pediátrico de Coimbra, CHUC, EPE, Ponta Delgada, Portugal.
J Child Orthop. 2018 Feb 1;12(1):36-41. doi: 10.1302/1863-2548.12.170099.
The overriding fifth toe is a congenital triplane deformity that may cause aesthetic and functional concerns in children and adolescents. This study aims to evaluate the results obtained when using Butler's arthroplasty to treat this forefoot deformity.
We performed a retrospective study, including all patients undergoing Butler's arthroplasty from January 1995 to December 2012. Clinical records were reviewed to determine age at date of surgery, gender, laterality, preoperative symptoms, success of deformity correction, postoperative pain, scarring, need for adapted shoe, rates of complications and recurrence. Patient satisfaction was evaluated through a telephone interview. All p-values < 0.05 were considered statistically significant.
A total of 21 patients were included in this study, the majority of which were male (57%), with a mean follow-up of 12 months (1 to 52). In the evaluation of the residual deformity (18 patients), 72% had excellent results, 17% good and 11% poor results. One patient had a keloid scar, three patients reported pain and three patients required adapted footwear. There was a partial recurrence of the deformity in three cases. The majority of patients (78%) were satisfied with the surgery. There was no statistically significant difference in terms of results, when comparing patients older and younger than seven years of age (p = 0.46).
Butler's operation is effective and safe in the treatment of the overriding fifth toe, yielding good functional results and patient satisfaction, with low rate of complications.
IV.
重叠第五趾是一种先天性三平面畸形，可能会给儿童和青少年带来美观和功能方面的问题。本研究旨在评估使用巴特勒关节成形术治疗这种前足畸形的效果。
我们进行了一项回顾性研究，纳入了1995年1月至2012年12月期间所有接受巴特勒关节成形术的患者。回顾临床记录以确定手术时的年龄、性别、患侧、术前症状、畸形矫正的成功率、术后疼痛、瘢痕形成、是否需要特制鞋、并发症发生率和复发率。通过电话访谈评估患者满意度。所有p值<0.05被认为具有统计学意义。
本研究共纳入21例患者，其中大多数为男性（57%），平均随访12个月（1至52个月）。在对残留畸形的评估中（18例患者），72%效果极佳，17%良好，11%较差。1例患者出现瘢痕疙瘩，3例患者报告疼痛，3例患者需要特制鞋。3例出现畸形部分复发。大多数患者（78%）对手术满意。比较7岁及以上和7岁以下患者的结果，无统计学显著差异（p = 0.46）。
巴特勒手术治疗重叠第五趾有效且安全，功能效果良好，患者满意度高，并发症发生率低。
IV级。
