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微创远端跖骨 Chevron 截骨术与开放技术的 5 年随访比较:一项随机对照试验。

Five-Year Follow-up of Minimally Invasive Distal Metatarsal Chevron Osteotomy in Comparison with the Open Technique: A Randomized Controlled Trial.

机构信息

OFZ-Orthopaedic and Foot Center Innsbruck, Innsbruck, Austria.

Orthopaedic Department (L.M., D.D., M.B., and M.L.) and the Department of Medical Statistics, Informatics and Health Economics (P.H.-P.), Medical University of Innsbruck, Innsbruck, Austria.

出版信息

J Bone Joint Surg Am. 2020 May 20;102(10):873-879. doi: 10.2106/JBJS.19.00981.

Abstract

BACKGROUND

The aim of the present prospective randomized study was to evaluate the long-term outcomes of minimally invasive chevron osteotomy as compared with open distal chevron osteotomy for the correction of hallux valgus deformity.

METHODS

A randomized controlled design was applied. The following parameters were assessed at 6 and 12 weeks, 9 months, and 5 years postoperatively: the American Orthopaedic Foot & Ankle Society (AOFAS) Forefoot Score, a visual analog scale (VAS) score for pain, and a patient-satisfaction score. In addition, several radiographic parameters for hallux valgus correction and joint degeneration were collected. Range of motion was also assessed. Thirty-nine of 47 feet were available for analysis at the time of the latest follow-up.

RESULTS

During the 5-year study period, the outcomes of the minimally invasive technique were comparable with those of the open technique. No significant differences were seen between the 2 groups within 5 years postoperatively in terms of clinical outcomes (VAS, AOFAS, satisfaction), radiographic outcomes, joint degeneration, or range of motion.

CONCLUSIONS

Five years after treatment, the outcome following minimally invasive distal chevron osteotomy is comparable with that for the open technique for hallux valgus surgery.

LEVELS OF EVIDENCE

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

本前瞻性随机研究的目的是评估微创 Chevron 截骨术与开放式远端 Chevron 截骨术治疗拇外翻畸形的长期疗效。

方法

采用随机对照设计。术后 6 周和 12 周、9 个月和 5 年时评估以下参数:美国矫形足踝协会(AOFAS)前足评分、疼痛视觉模拟评分(VAS)和患者满意度评分。此外,还收集了用于评估拇外翻矫正和关节退变的几个影像学参数。还评估了活动范围。在最后一次随访时,有 47 只脚中的 39 只可供分析。

结果

在 5 年的研究期间,微创技术的结果与开放技术相当。在术后 5 年内,2 组在临床结果(VAS、AOFAS、满意度)、影像学结果、关节退变或活动范围方面均无显著差异。

结论

治疗后 5 年,微创远端 Chevron 截骨术的结果与开放式拇外翻手术相当。

证据水平

治疗水平 I. 有关证据水平的完整描述,请参见作者说明。

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