Seo Jae Hyeon, Lee Ho Seong, Choi Young Rak, Park Seung Hwan, Lee Jae Hyung, Chun Hannah
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Orthopedic Surgery, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, South Korea.
Foot Ankle Int. 2021 Jul;42(7):919-928. doi: 10.1177/1071100721996707. Epub 2021 Mar 29.
The purpose of this study was to compare radiographic outcomes of simultaneous bilateral and unilateral distal chevron metatarsal osteotomy (DCMO) in hallux valgus patients aged ≥60 years.
This retrospective study analyzed consecutive outcomes of simultaneous bilateral DCMO and unilateral DCMO performed between June 2010 and August 2018 in 90 feet of 60 patients. Thirty patients underwent simultaneous bilateral DCMO, and 30 underwent unilateral DCMO. Comparative analysis of radiographic and clinical parameters between a simultaneous bilateral DCMO group (SB) and a unilateral DCMO group (U) was performed.
Mean age at surgery (65.7±4.8 vs 65.2±5.2 years), mean length of follow-up period (20.0 vs 18.6 months), and preoperative radiographic parameters were similar between the 2 groups (SB vs U). Mean hallux valgus angle (HVA) improved from 34.2 to 5.4 degrees (correction angle SB 28.8 vs U 28.8 degrees). Mean first-to-second intermetatarsal angle improved from 15.8 to 6.8 degrees (correction angle SB 8.9 vs U 8.9 degrees). Hallux varus deformity was observed in 4 feet (SB 3 vs U 1), and mechanical instability with callus formation in 1 foot in the unilateral group.
DCMOs in patients aged ≥60 years were radiographically effective and safe, even performed in one stage bilaterally. Radiographic parameters were similar in patients who underwent simultaneous bilateral and unilateral DCMO.
Level III, retrospective cohort study.
本研究旨在比较年龄≥60岁的拇外翻患者同期双侧与单侧远端V形截骨术（DCMO）的影像学结果。
这项回顾性研究分析了2010年6月至2018年8月间60例患者90只足同期双侧DCMO和单侧DCMO的连续结果。30例患者接受同期双侧DCMO，30例接受单侧DCMO。对同期双侧DCMO组（SB）和单侧DCMO组（U）的影像学和临床参数进行了比较分析。
两组患者的手术平均年龄（65.7±4.8岁 vs 65.2±5.2岁）、平均随访时间（20.0个月 vs 18.6个月）以及术前影像学参数相似（SB组 vs U组）。平均拇外翻角（HVA）从34.2度改善至5.4度（矫正角度SB组为28.8度，U组为28.8度）。平均第一、二跖骨间角从15.8度改善至6.8度（矫正角度SB组为8.9度，U组为8.9度）。在4只足中观察到拇内翻畸形（SB组3只，U组1只），单侧组有1只足出现伴有骨痂形成的机械性不稳定。
年龄≥60岁患者的DCMO在影像学上有效且安全，即使是双侧一期手术。同期双侧和单侧DCMO患者的影像学参数相似。
三级，回顾性队列研究。
