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Valenti 切除术关节成形术治疗拇僵硬:系统评价。

Valenti resection arthroplasty for hallux rigidus: A systematic review.

机构信息

Clinica Ortopedica - IRCCS Ospedale Policlinico San Martino, Università di Genova, Largo Rosanna Benzi, 10, 16132, Genoa, GE, Italy.

Department of Orthopedics and Trauma Surgery, University of Verona, Italy.

出版信息

Foot Ankle Surg. 2020 Dec;26(8):838-844. doi: 10.1016/j.fas.2019.11.009. Epub 2019 Dec 5.

Abstract

BACKGROUND

Valente Valenti proposed in 1976 a "V" resection of the first metatarsophalangeal joint (MPT1) on the sagittal plane for advanced stages of hallux limitus/rigidus, preserving length of the first ray, flexor hallux brevis and sesamoid function. The available literature concerning correct indications, management and clinical outcomes of the Valenti procedure (VP) and its modifications in patients affected by hallux limitus/rigidus was systematically analyzed.

METHODS

Titles and abstracts of all selected articles were independently screened by two authors to assess their suitability to the research focus.

RESULTS

Selection produced 8 articles as full-text, for a total of 347 patients, with a mean follow-up of 6±7.1 (range 0.2-17.5) years. Most common complication was transient sesamoiditis in 21 (7.4%) patients. No substantial differences in clinical outcomes were found between the original and modified techniques.

CONCLUSIONS

VP appears to allow an early recovery with few complications, if compared to fusion, interposition arthroplasties or osteotomies. The wide joint resection does not prevent, if necessary, further procedures such as fusion or implants.

LEVEL OF EVIDENCE

Level I, systematic review.

摘要

背景

瓦伦蒂(Valente)于 1976 年提出在矢状面上对第一跖趾关节(MPT1)进行“V”形切除,用于治疗严重的拇趾僵硬/强直,保留第一跖骨的长度、短屈拇肌和籽骨的功能。系统分析了关于瓦伦蒂手术(VP)及其在拇趾僵硬/强直患者中的改良术式的适应证、处理方法和临床结果的相关文献。

方法

两名作者分别独立筛选所有入选文章的标题和摘要,以评估其是否符合研究重点。

结果

选择了 8 篇全文文章,共 347 例患者,平均随访 6±7.1 年(范围 0.2-17.5 年)。最常见的并发症是 21 例(7.4%)患者的短暂性籽骨炎。与融合术、间置关节成形术或截骨术相比,原始技术和改良技术的临床结果没有显著差异。

结论

与融合术、间置关节成形术或截骨术相比,VP 早期恢复快,并发症少。广泛的关节切除并不能防止必要时进行进一步的手术,如融合或植入物。

证据等级

I 级,系统评价。

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