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跗跖关节融合术治疗拇外翻前后影像学测量比较。

Comparison of Radiographic Measurements Before and After Triplane Tarsometatarsal Arthrodesis for Hallux Valgus.

机构信息

Surgeon, Foot & Ankle Center of Iowa/Midwest Bunion Center, Ankeny, IA.

Student, Des Moines University College of Podiatric Medicine and Surgery, Des Moines, IA.

出版信息

J Foot Ankle Surg. 2020 Mar-Apr;59(2):291-297. doi: 10.1053/j.jfas.2019.08.020.

Abstract

We present a comparison of preoperative and final postoperative first ray measurements in 109 feet after triplane tarsometatarsal arthrodesis at a mean follow-up time of 17.4 months. Preoperative and final postoperative first ray variables including intermetatarsal angle (IMA), hallux valgus angle (HVA), tibial sesamoid position (TSP), distal metatarsal articular angle (DMAA), Seiberg index, metatarsal rotation angle (MRA), sesamoid subluxation, osseous union, and hardware failure were evaluated. Measurements were made by consistently using the mid-diaphyseal line of the bone segments for both preoperative and postoperative assessments. The mean preoperative HVA, IMA, and TSP were 22.9°, 13.3°, and 4.6. The mean differences (95% confidence interval) in preoperative and postoperative values were -14.9° (-16.3° to -13.4°) for HVA, -7.7° (-8.2° to -7.2°) for IMA, and -2.6 (-2.8 to -2.3) for TSP. Among bunions with MRA measurements, the mean difference was -12.3° (-14.5° to -10.0°). The preoperative to postoperative DMAA decreased by a mean of -14.2° (-15.9° to -12.6°). The results of this study suggest that triplane tarsometatarsal arthrodesis produces appropriate correction of hallux valgus radiographic parameters.

摘要

我们比较了 109 例接受三平面跗跖关节融合术患者的术前和末次随访时第一跖骨的放射线测量值,平均随访时间为 17.4 个月。评估的术前和末次随访时第一跖骨变量包括:跖骨间角(IMA)、拇外翻角(HVA)、跖骨籽骨位置(TSP)、远节跖骨关节角(DMAA)、Seiberg 指数、跖骨旋转角(MRA)、籽骨半脱位、骨愈合和内固定失败。测量时始终使用骨段的骨干中部线进行术前和术后评估。术前 HVA、IMA 和 TSP 的平均值分别为 22.9°、13.3°和 4.6°。术前和术后差值的平均值(95%置信区间)分别为 HVA 的-14.9°(-16.3°至-13.4°)、IMA 的-7.7°(-8.2°至-7.2°)和 TSP 的-2.6°(-2.8°至-2.3°)。在进行 MRA 测量的拇囊炎中,平均差值为-12.3°(-14.5°至-10.0°)。术前到术后 DMAA 平均减少了 14.2°(-15.9°至-12.6°)。本研究结果表明,三平面跗跖关节融合术可适当矫正拇外翻的放射学参数。

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