Götze Marco, Hasmann Sandra Elisabeth, Hofmann Ulf Krister, Walter Christian, Mittag Falk
Department of Orthopaedic Surgery, University Hospital Tübingen, Tübingen, Germany.
Department of Internal Medicine IV, Ludwig-Maximilians-University Munich, Munich. Germany.
Acta Ortop Bras. 2019 Jan-Feb;27(1):16-19. doi: 10.1590/1413-785220192701174203.
This is a descriptive study to report our method of operative correction for patients with hallux valgus deformities.
From 2006 to 2012, 516 consecutive patients (601 feet) with hallux valgus deformities were treated surgically in our department after conservative treatments were exhausted. The hallux valgus angle, intermetatarsal angle, distal metatarsal articular angle, and degree of osteoarthritis in the first metatarsophalangeal joint were measured on preoperative plain radiographs of the weight-bearing forefoot.
Young patients with severe intermetatarsal deviation received a combined proximal and distal osteotomy of the first metatarsal (n = 21). Patients with low intermetatarsal deviation received a distal metatarsal chevron osteotomy (n = 196), whereas patients with severe intermetatarsal deviation and less flexible deformities without osteoarthritis received a basal metatarsal osteotomy with a distal soft tissue procedure (n = 173). Elderly active patients with osteoarthritis in the first metatarsophalangeal joint received an arthrodesis (n = 100) or resection arthroplasty (n = 58).
Determining a few simple angles on plain radiographs of the weight-bearing forefoot in combination with the age and level of activity of patients can help simplify the operative correction method by using the schema we developed. .
本研究为描述性研究，旨在报告我们针对拇外翻畸形患者的手术矫正方法。
2006年至2012年，在保守治疗无效后，我科对516例连续的拇外翻畸形患者（601足）进行了手术治疗。在负重前足的术前X线平片上测量拇外翻角、跖间角、第一跖骨头关节角以及第一跖趾关节的骨关节炎程度。
跖间严重偏移的年轻患者接受了第一跖骨近端和远端联合截骨术（n = 21）。跖间偏移程度低的患者接受了第一跖骨远端V形截骨术（n = 196），而跖间严重偏移且畸形灵活性较差且无骨关节炎的患者接受了第一跖骨基底截骨术并联合远端软组织手术（n = 173）。第一跖趾关节患有骨关节炎的老年活动患者接受了关节融合术（n = 100）或切除关节成形术（n = 58）。
结合患者的年龄和活动水平，在负重前足的X线平片上测定几个简单的角度，有助于通过我们制定的方案简化手术矫正方法。
