Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
Foot Ankle Int. 2021 Jun;42(6):798-804. doi: 10.1177/1071100720982975. Epub 2021 Jan 15.
The prevalence of hallux valgus increases with age. However, no studies have compared the effectiveness of surgical correction among different age groups. This study investigated the influence of age on clinical and radiological outcomes following hallux valgus surgery.
Patients who underwent correction for hallux valgus at an academic hospital were stratified into 3 age groups: younger (<50 years), middle-aged (50-59 years), and older (≥60 years). Functional outcomes and satisfaction questionnaires were collected preoperatively and at 6 months and 2 years postoperatively. Radiological recurrence and reoperations were recorded at follow-up. There were 193 patients (93% female): 34 younger, 74 middle-aged, and 85 older.
The preoperative hallux valgus angle was significantly greater in older patients ( < .001). The older group had 3 perioperative complications ( = .144) and showed a trend toward a longer hospital stay ( = .083). There was no difference in visual analog scale, American Orthopaedic Foot & Ankle Society score, or SF-36 among the groups at 6 months or 2 years. Using multiple regression, age was not associated with any outcome score. The satisfaction rates were 82%, 78%, and 83% in the young, middle-aged, and older groups, respectively ( = .698). There was no difference in the number of reoperations at a mean follow-up of 9.2 ± 2.2 years ( = .778), and no patients underwent reoperation for recurrent hallux valgus. The risk of recurrence was 5 times higher in older patients compared with younger patients (OR, 5.15; 95% CI, 1.10-24.03; = .037).
Age did not influence the perioperative, functional, or subjective outcomes following hallux valgus surgery. However, older patients should be counseled on the higher risk of recurrence following surgical correction.
Therapeutic, level III, retrospective comparative series.
拇外翻的患病率随年龄增长而增加。然而，目前尚无研究比较不同年龄段患者的手术矫正效果。本研究旨在探讨年龄对拇外翻手术临床和影像学结果的影响。
在一家学术医院接受拇外翻矫正手术的患者，根据年龄分为 3 组：年轻组（<50 岁）、中年组（50-59 岁）和老年组（≥60 岁）。术前、术后 6 个月和 2 年收集功能和满意度问卷。在随访中记录放射学复发和再次手术情况。共纳入 193 例患者（93%为女性）：34 例年轻组、74 例中年组和 85 例老年组。
老年组患者术前拇外翻角显著更大（<0.001）。老年组有 3 例围手术期并发症（=0.144），住院时间延长趋势（=0.083）。3 组患者在术后 6 个月和 2 年时的视觉模拟评分、美国矫形足踝协会评分和 SF-36 评分均无差异。多因素回归分析显示，年龄与任何结局评分均无关。年轻、中年和老年组的满意度分别为 82%、78%和 83%（=0.698）。在平均 9.2±2.2 年的随访中，再次手术率无差异（=0.778），且无患者因复发拇外翻而再次手术。与年轻患者相比，老年患者的复发风险高 5 倍（OR，5.15；95%CI，1.10-24.03；=0.037）。
年龄并不影响拇外翻手术后的围手术期、功能或主观结局。然而，应向老年患者告知手术矫正后复发风险较高。
治疗性，III 级，回顾性比较研究。
