Professor of Neuroscience & Population Genetics, Department of Anatomy, Biochemistry and Human Genetics; Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Professor of Neuroscience & Population Genetics, Department of Anatomy, Biochemistry and Human Genetics; Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Foot Ankle Surg. 2020 Feb;26(2):156-162. doi: 10.1016/j.fas.2019.01.006. Epub 2019 Jan 26.
The use of percutaneous surgery is currently very common in foot and ankle surgery. The following prospective open-label patient-preference based study compares the traditional open technique versus the percutaneous surgery technique.
The current study describes the results of 287 patients operated due to forefoot deformities either by open surgery or percutaneously. 96 of them underwent hallux valgus corrective surgery. The rest had lesser toe deformities. They were followed for a period of up to 24 months, to assess the surgery related pain, complications, and patient satisfaction. 112 patients were operated using a conventional open technique were compared to 175 patients treated using a percutaneous technique. Technique choice was left to the patient preference, though older patients with disturbed blood flow, were advised to undergo percutaneous surgery.
There is less pain using the percutaneous techniques relative to the open technique during the first 6 post-operative weeks. The 6, and 24 months FAOS score is similar in both groups. Complications are rare in any of the groups, with a significantly higher ASEPSIS score in the open surgery group.
Percutaneous forefoot surgery appears safe and efficacious, demonstrating equal radiographic (in a 96 strong cohort of hallux valgus patients) and clinical results at six and 24 months. Due to less post-operative pain, and less infection risk it appears that percutaneous techniques are superior to open technique in some respects of treatment and indeed the PGIC of patients was significantly higher in this group.
目前，经皮手术在足踝外科中应用非常普遍。本前瞻性、开放性、基于患者偏好的研究比较了传统的开放技术与经皮手术技术。
本研究描述了 287 例因前足畸形而接受开放手术或经皮手术的患者的结果。其中 96 例接受了拇外翻矫正手术，其余患者有小趾畸形。对这些患者进行了长达 24 个月的随访，以评估与手术相关的疼痛、并发症和患者满意度。112 例患者采用传统的开放技术，175 例患者采用经皮技术。尽管对于血流紊乱的老年患者建议采用经皮手术，但手术技术的选择取决于患者的偏好。
与开放技术相比，经皮技术在术后 6 周内疼痛明显减轻。两组患者的 FAOS 评分在术后 6 个月和 24 个月时相似。两组患者的并发症均很少，开放手术组的 ASEPSIS 评分明显较高。
经皮前足手术安全有效，在 6 个月和 24 个月时的放射学（在 96 例拇外翻患者队列中）和临床结果均相似。由于术后疼痛减轻和感染风险降低，经皮技术在某些治疗方面似乎优于开放技术，患者的 PGIC 确实在该组中明显更高。
