Ferreira Gabriel Ferraz, Borges Vinícius Quadros, Moraes Leonardo Vinícius de Matos, Stéfani Kelly Cristina
Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Instituto Prevent Senior, São Paulo, São Paulo, Brazil.
Foot and Ankle Surgery Group, Orthopedics and Traumatology Department, Hospital do Campo Limpo, São Paulo, São Paulo, Brazil.
PLoS One. 2021 Feb 17;16(2):e0242496. doi: 10.1371/journal.pone.0242496. eCollection 2021.
The objective of the study is to compare the radiographic and clinical results of two techniques for the treatment of hallux valgus that have the same indication, the open scarf/Akin (SA) technique and the percutaneous Chevron/Akin (PECA).
A meta-analysis was performed with the studies found during a systematic review of articles included in electronic databases until 30 May 2020. The pooled analysis was summarized according to clinical outcomes, such as visual analog pain scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) score, radiographic outcomes and complications, with a 95% confidence interval.
Three studies comparing the open scarf/Akin (SA) versus the PECA techniques were added to the analysis, corresponding to 235 feet, 102 in the PECA group and 133 in the SA. The final mean difference in the hallux valgus angle was 0.80 degrees and in the intermetatarsal angle 0.53, in the last radiographic evaluation. In the AOFAS score, the final mean difference was 4.97 points and in the VAS 0.14 in relation to the last clinical evaluation. Exposure to radiation during the surgical procedure was higher in the PECA group with a mean of 35.53 seconds.
The PECA surgical technique for the treatment of hallux valgus when compared with SA demonstrated similar radiographic correction, pain and function after six months of follow-up but with a longer radiation exposure time.
REGISTER OF SYSTEMATIC REVIEW (PROSPERO): CRD42018096613.
本研究的目的是比较两种具有相同适应症的拇外翻治疗技术的影像学和临床结果，即开放式Scarf/Akin（SA）技术和经皮Chevron/Akin（PECA）技术。
对截至2020年5月30日在电子数据库中系统检索到的文章进行荟萃分析。根据临床结果（如视觉模拟疼痛量表（VAS）和美国矫形足踝协会（AOFAS）评分）、影像学结果和并发症，以95%置信区间进行汇总分析。
三项比较开放式Scarf/Akin（SA）与PECA技术的研究被纳入分析，共涉及235只脚，PECA组102只，SA组133只。在最后一次影像学评估中，拇外翻角的最终平均差异为0.80度，跖间角为0.53度。在AOFAS评分中，最后一次临床评估的最终平均差异为4.97分，VAS评分为0.14。PECA组手术过程中的辐射暴露更高，平均为35.53秒。
与SA技术相比，PECA手术技术治疗拇外翻在随访六个月后显示出相似的影像学矫正、疼痛和功能，但辐射暴露时间更长。
系统评价注册（PROSPERO）：CRD42018096613。
