Chief Resident, Postgraduate Year 3, Beaumont Health Wayne Podiatric Foot and Ankle Surgical Residency, Beaumont Health Wayne, Wayne, MI.
Director, Beaumont Health Wayne Podiatric Foot and Ankle Surgical Residency, Beaumont Health Wayne, Wayne, MI.
J Foot Ankle Surg. 2020 Sep-Oct;59(5):979-983. doi: 10.1053/j.jfas.2020.04.007. Epub 2020 Jul 1.
Hallux abducto valgus is a functionally disabling deformity with lateral deviation of the hallux and medial prominence of the first metatarsal head. Various surgical techniques have been used in the treatment of this deformity. In this retrospective review, we assess the outcomes of proximal closing base wedge osteotomy (CBWO). A single-surgeon database was reviewed for patients who underwent proximal CBWO between January 1, 2012, and December 31, 2017. A total of 101 patients were identified with a mean age of 49 years (range 13 to 80) and mean body mass index of 29 kg/m (range 19 to 53). The medical records were reviewed for smoking status, time to heal, rates of nonunion, shortening of the first metatarsal, intermetatarsal angle, hallux valgus angle, elevatus, mean loss of correction, complication rates, and pain scores. Pre- and postoperative variables were compared using Student's t test for continuous variables. The mean pre- and postoperative intermetatarsal angles were 15.46° (range 10° to 21°) and 3.77° (range 0° to 10°; p < .05). The mean pre- and postoperative hallux abductus valgus angles were 34.57° (range 12° to 60°) and 9.24° (range, 0° to 30°;p < .05). The mean metatarsal length shortening was 3.72 mm, and the mean postoperative elevatus was 2.73 mm. We have demonstrated excellent outcomes of CBWO with correction of intermetatarsal and hallux valgus angles. This procedure allows for superior reduction of moderate to severe intermetatarsal angles in rigid first rays. The mean postoperative elevatus of 2.73 did not result in any adverse sequelae.
拇外翻是一种功能性致残畸形，表现为拇趾向外侧偏斜，第一跖骨头内侧突出。已经采用了各种手术技术来治疗这种畸形。在这项回顾性研究中，我们评估了近端闭合基底楔形截骨术（CBWO）的治疗效果。对 2012 年 1 月 1 日至 2017 年 12 月 31 日期间接受近端 CBWO 的单外科医生数据库中的患者进行了回顾。共确定了 101 例患者，平均年龄为 49 岁（范围 13 至 80 岁），平均体重指数为 29kg/m（范围 19 至 53）。回顾了患者的吸烟状况、愈合时间、骨不连率、第一跖骨缩短、跖骨间角、拇外翻角、elevatus、平均矫正丢失量、并发症发生率和疼痛评分。使用学生 t 检验比较了术前和术后变量。术前和术后的跖骨间角分别为 15.46°（范围 10°至 21°）和 3.77°（范围 0°至 10°；p<.05）。术前和术后拇趾外展角分别为 34.57°（范围 12°至 60°）和 9.24°（范围 0°至 30°；p<.05）。平均跖骨缩短 3.72mm，术后平均 elevatus 为 2.73mm。我们证明了 CBWO 治疗跖骨间和拇外翻角的良好效果。该手术可矫正中重度僵硬第一跖骨的跖骨间角。术后 elevatus 平均为 2.73mm，无任何不良后果。
