Patel Shelain, Garg Parag, Fazal M Ali, Shahid Muhammad S, Park Derek H, Ray Pinak S
Department of Orthopaedics, Barnet General Hospital, Wellhouse Lane, London, UK.
Foot Ankle Spec. 2019 Jun;12(3):228-232. doi: 10.1177/1938640018782608. Epub 2018 Jun 18.
. The reverse camber shoe is commonly used after hallux valgus corrective surgery to offload the forefoot but is associated with back pain and poor compliance. Recent designs of postoperative shoes may obviate the need for a reverse camber. The purpose of this study was to compare the effects of a reverse camber shoe and a noncambered shoe with transitional rigidity after hallux valgus correction. . A cohort of 80 feet was prospectively studied undergoing surgery at a single NHS trust. The first 40 feet received the reverse cambered Jura Medical Off-loader Heel shoe and the subsequent 40 feet received the noncambered DonJoy Podalux shoe. No demographic differences existed between the groups and data were collected at 2 weeks, 6 weeks, and 6 months. The Manchester-Oxford Foot Questionnaire (MOXFQ), a 5-question survey and dichotomous question about back pain was used to assess clinical outcome and radiographs were reviewed by 2 orthopaedic surgeons to monitor for loss of correction. . Both groups experienced comparable improvements in MOXFQ and shoe satisfaction from 2 weeks compared with 6 weeks. Six patients experienced back pain in the reverse cambered shoe group and none in the noncambered shoe group. Five patients stopped using the reverse cambered shoe during the first 6 weeks after surgery and none stopped using their prescribed noncambered shoe. No loss of corrections were observed in either group. . Both shoe designs gave equal foot specific functional and radiological outcomes, but the noncambered shoe with transitional rigidity was associated with less back pain and better compliance. Level II: Prospective comparative study.
拇外翻矫正手术后通常使用反弯鞋来减轻前足压力,但会导致背痛且患者依从性差。近期的术后鞋设计可能无需使用反弯鞋。本研究的目的是比较拇外翻矫正后反弯鞋和具有过渡刚性的无弯鞋的效果。
在一家NHS信托机构对80只脚进行了前瞻性研究,这些脚均接受了手术。前40只脚穿反弯的Jura Medical Off-loader Heel鞋,随后的40只脚穿无弯的DonJoy Podalux鞋。两组之间在人口统计学上无差异,并在术后2周、6周和6个月收集数据。使用曼彻斯特 - 牛津足部问卷(MOXFQ),这是一项包含5个问题的调查以及一个关于背痛的二分法问题,来评估临床结果,同时由2名骨科医生复查X光片以监测矫正丢失情况。
与6周时相比,两组在术后2周时MOXFQ和鞋满意度方面的改善情况相当。反弯鞋组有6名患者出现背痛,无弯鞋组无患者出现背痛。5名患者在术后前6周内停止使用反弯鞋,而无人停止使用所开的无弯鞋。两组均未观察到矫正丢失情况。
两种鞋的设计在足部特定功能和影像学结果方面相当,但具有过渡刚性的无弯鞋与较少的背痛和更好的依从性相关。 二级:前瞻性比较研究。