Sever Gökhan Bülent, Aykanat Faruk, Cankuş Cenk
Department of Orthopaedic Surgery, Private Sani Konukoğlu Hospital.
Department of Orthopaedic Surgery, Sanko University, Gaziantep, Turkey.
Medicine (Baltimore). 2019 Jun;98(24):e15969. doi: 10.1097/MD.0000000000015969.
The purpose of this study is to investigate clinical and radiographic differences between longitudinal capsulorrhaphy and inverted L-type capsulorrhaphy in patients diagnosed with hallux valgus (HV) to whom distal chevron osteotomy and HV distal soft-tissue procedure combination surgery was implemented.A total of 36 patients and 48 feet on whom distal chevron osteotomy and HV distal soft-tissue procedure combination surgery was implemented upon diagnosis of HV were included in the study. The patients were separated into 2 groups according to capsulorrhaphy technique, as group 1 (24 feet) wherein longitudinal capsulorrhaphy was implemented and group 2 (24 feet) wherein inverted-L type capsulorrhaphy was implemented. Both groups were compared preoperatively and postoperatively in terms of American Orthopedic Foot and Ankle Society HV score, visual analogue scale (VAS) pain score, HV angle (HVA), intermetatarsal angle and complications.Comparing the radiological data of both groups, the decrease in terms of HVA was significant in Group 2; however, no significant difference was detected in terms of other data. Postoperative hallux varus was observed 1 one patient in Group 2; however, this case was not statistically significant.In the distal chevron osteotomy and distal soft-tissue procedure combination, applied as a HV correction surgery technique, comparing inverted L-type capsulorrhaphy with longitudinal capsulorrhaphy techniques, it was observed that inverted L-type capsulorrhaphy was more effective in correcting the HVA. However, it should be kept in mind that L-type capsulorrhaphy is also the technique wherein hallux varus complication occurred. As a result, the conclusion was reached that both techniques are applicable and effective in HV correction surgery and the choice should be made by considering the command of the surgeon on the technique.
本研究的目的是调查在接受远端V形截骨术和拇外翻(HV)远端软组织手术联合手术的拇外翻患者中,纵向关节囊缝合术和倒L形关节囊缝合术之间的临床和影像学差异。本研究纳入了36例患者共48只脚,这些患者在诊断为HV后接受了远端V形截骨术和HV远端软组织手术联合手术。根据关节囊缝合技术将患者分为2组,第1组(24只脚)采用纵向关节囊缝合术,第2组(24只脚)采用倒L形关节囊缝合术。比较两组术前和术后的美国矫形足踝协会HV评分、视觉模拟量表(VAS)疼痛评分、HV角(HVA)、跖间角和并发症情况。比较两组的放射学数据,第2组HVA的降低有显著意义;然而,在其他数据方面未检测到显著差异。第2组有1例患者术后出现拇内翻;然而,该病例无统计学意义。在作为HV矫正手术技术应用的远端V形截骨术和远端软组织手术联合手术中,比较倒L形关节囊缝合术和纵向关节囊缝合术,发现倒L形关节囊缝合术在矫正HVA方面更有效。然而,应记住L形关节囊缝合术也是发生拇内翻并发症的技术。因此,得出的结论是,两种技术在HV矫正手术中均适用且有效,应根据外科医生对该技术的掌握情况做出选择。