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单纯微创关节镜下趾间关节切除术治疗僵硬性拇趾的中期结果

Intermediate-term results of isolated minimally invasive arthroscopic cheilectomy in the treatment of hallux rigidus.

作者信息

Hickey Benjamin A, Siew Debbie, Nambiar Mithun, Bedi Harvinder S

机构信息

OrthoSport Victoria, Level 5, 89 Bridge Road, Richmond, VIC, 3121, Australia.

Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC, 3800, Australia.

出版信息

Eur J Orthop Surg Traumatol. 2020 Oct;30(7):1277-1283. doi: 10.1007/s00590-020-02702-6. Epub 2020 May 18.

Abstract

AIM

The aim of this study was to determine the intermediate-term results of minimally invasive cheilectomy of the first MTPJ using a high-torque low-speed burr and arthroscopic debridement.

METHODS

A consecutive series of patients who underwent isolated unilateral minimally invasive cheilectomy of the first MTPJ were contacted by telephone. A questionnaire was used to assess patient satisfaction and complications. Patients with less than 2 years of follow-up were excluded.

RESULTS

Thirty-six patients completed the study. Mean patient age at time of surgery was 50.0 years (range 24.5-67.0). Mean follow-up was 4.69 years (range 2.0-7.3). Thirty patients (83%) reported they would recommend the procedure. Mean postoperative improvement in pain was 69% (range 0-100). Twenty-seven (84%) of patients reported either no pain (28%) or mild pain (56%). For patients who reported any pain, the mean pain experienced was rated as 3.4 out of 10 (range 1-9). Twenty-nine (81%) patients reported they could wear a 'fashionable' shoe postoperatively. One patient experienced a delayed rupture of the extensor hallucis longus at 6 months postsurgery. One patient underwent further arthroscopic cheilectomy. No patient required conversion to fusion of the first MTPJ.

CONCLUSION

Minimally invasive cheilectomy of the first MTPJ using high-torque low-speed burr and arthroscopic debridement results in high patient satisfaction with a low rate of complications at intermediate follow-up.

摘要

目的

本研究的目的是确定使用高扭矩低速磨钻和关节镜清创术对第一跖趾关节(MTPJ)进行微创切骨术的中期结果。

方法

通过电话联系了一系列连续接受第一跖趾关节孤立性单侧微创切骨术的患者。使用问卷评估患者满意度和并发症情况。随访时间少于2年的患者被排除。

结果

36名患者完成了研究。手术时患者的平均年龄为50.0岁(范围24.5 - 67.0岁)。平均随访时间为4.69年(范围2.0 - 7.3年)。30名患者(83%)表示他们会推荐该手术。术后疼痛平均改善69%(范围0 - 100)。27名(84%)患者报告无疼痛(28%)或轻度疼痛(56%)。对于报告有任何疼痛的患者,所经历的平均疼痛评分为10分中的3.4分(范围1 - 9)。29名(81%)患者报告术后可以穿“时尚”鞋子。1名患者在术后6个月出现拇长伸肌延迟断裂。1名患者接受了进一步的关节镜切骨术。没有患者需要转为第一跖趾关节融合术。

结论

使用高扭矩低速磨钻和关节镜清创术对第一跖趾关节进行微创切骨术,在中期随访时患者满意度高,并发症发生率低。

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