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使用可吸收材料行延长型远端楔形截骨术与 Akin 截骨术治疗中重度拇外翻

Extended Distal Chevron Osteotomy and Akin Osteotomy Using Bioabsorbable Materials for Treatment of Moderate to Severe Hallux Valgus.

机构信息

Assistant Professor, Department of Orthopedic Surgery, Konyang University Hospital, Daejeon, South Korea.

Associate Professor, Department of Orthopedic Surgery, Chungnam National University Hospital, Daejeon, South Korea.

出版信息

J Foot Ankle Surg. 2021 Nov-Dec;60(6):1110-1116. doi: 10.1053/j.jfas.2021.01.010. Epub 2021 Apr 21.

Abstract

The purpose of this study was to investigate the suitability of bioabsorbable materials for fixation of extended distal chevron osteotomy and Akin osteotomy for the treatment of moderate to severe hallux valgus. We performed a retrospective analysis of extended distal chevron osteotomy and Akin osteotomy for the treatment of moderate to severe hallux valgus (33 patients, 42 feet). Fixation of extended distal chevron osteotomy and Akin osteotomy was performed using poly-l-lactic acid pins and polylactic acid/polyglycolic acid copolymer sutures, respectively. The radiological outcomes were evaluated based on the preoperative and 3-year follow-up intermetatarsal angle, hallux valgus angle, and hallux interphalangeal angle. The clinical results were assessed according to 3-year follow-up Manchester-Oxford Foot Questionnaire scores, patient satisfaction, and postoperative complications. All radiological and clinical results were compared with those of a control group treated with metallic implants. The mean 3-year follow-up intermetatarsal angle, hallux valgus angle, and hallux interphalangeal angle were significantly corrected from the preoperative values (all p < .001). The mean 3-year follow-up Manchester-Oxford Foot Questionnaire scores score was significantly improved from the preoperative values (p < .001). Regarding patient satisfaction, 88.1% of the patients reported good to excellent results. A total of seven complications were reported. All radiological and clinical results were comparable with those of control group treated with metallic implant. Based on these results, we recommend using bioabsorbable materials as another reliable device for fixation of extended distal chevron osteotomy and Akin osteotomy even for the treatment of moderate to severe hallux valgus.

摘要

本研究旨在探讨生物可吸收材料在固定延长的远端跖骨切骨术和 Akin 截骨术治疗中重度拇外翻中的适用性。我们对 33 例(42 足)中重度拇外翻患者进行了延长的远端跖骨切骨术和 Akin 截骨术的回顾性分析。采用聚 L-乳酸钉和聚乳酸/聚乙醇酸共聚物缝线分别固定延长的远端跖骨切骨术和 Akin 截骨术。根据术前和 3 年随访的跖骨间角、拇外翻角和跖趾关节角评估影像学结果。根据 3 年随访的曼彻斯特-牛津足部问卷评分、患者满意度和术后并发症评估临床结果。将所有影像学和临床结果与金属植入物治疗的对照组进行比较。平均 3 年随访时,跖骨间角、拇外翻角和跖趾关节角均较术前明显矫正(均 P<.001)。平均 3 年随访时曼彻斯特-牛津足部问卷评分明显高于术前(P<.001)。在患者满意度方面,88.1%的患者报告结果良好至优秀。共报告了 7 例并发症。所有影像学和临床结果与金属植入物治疗的对照组相当。基于这些结果,我们建议即使治疗中重度拇外翻,也可以将生物可吸收材料作为固定延长的远端跖骨切骨术和 Akin 截骨术的另一种可靠装置。

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