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微创远端 Chevron 截骨术的中期结果:荟萃分析比较与微创 Reverdin-Isham 截骨术。

Midterm Results Following Minimally Invasive Distal Chevron Osteotomy: Comparison With the Minimally Invasive Reverdin-Isham Osteotomy by Means of Meta-analysis.

机构信息

OFZ Innsbruck, Orthopedic and Foot Center Innsbruck, Innsbruck, Austria.

Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria.

出版信息

In Vivo. 2021 Jul-Aug;35(4):2187-2196. doi: 10.21873/invivo.12490.

Abstract

BACKGROUND/AIM: To date, multiple different surgical techniques have been established for hallux valgus surgery, with each technique having its unique advantages and limitations. The open distal chevron osteotomy is widely accepted, but increasing patient demands have led several minimally invasive (MIS) techniques to be described in recent years. The aim of this study was to compare outcomes after minimally invasive (MIS) distal chevron osteotomy and the minimally invasive Reverdin-Isham method.

PATIENTS AND METHODS

We assessed clinical and radiographic outcomes after MIS chevron osteotomy in 57 feet of 49 consecutive patients with a mean follow-up of 58.9 (range=39.0-85.4) months. Outcomes after MIS Reverdin-Isham osteotomy were analyzed by means of a systematic literature review with a minimum follow-up of 6 months.

RESULTS

Radiographic outcomes were significantly better in the MIS chevron cohort for intermetatarsal angle (p<0.001), hallux valgus angle and distal metacarpal articular angle (p<0.05). Concerning clinical outcomes, both methods provided comparable improvement.

CONCLUSION

MIS distal chevron osteotomy in mild to moderate hallux valgus deformity correction results in superior radiographic outcomes compared to the MIS Reverdin-Isham osteotomy. Sufficient correction of IMA cannot be achieved with the MIS Reverdin-Isham osteotomy.

摘要

背景/目的:迄今为止,已经有多种不同的手术技术被应用于拇外翻手术,每种技术都有其独特的优势和局限性。开放式远端跖骨楔骨截骨术被广泛接受,但随着患者需求的增加,近年来已经描述了几种微创(MIS)技术。本研究旨在比较微创(MIS)远端跖骨楔骨截骨术和微创Reverdin-Isham 法的结果。

患者和方法

我们评估了 49 例连续患者的 57 足微创跖骨楔骨截骨术后的临床和影像学结果,平均随访时间为 58.9 个月(范围为 39.0-85.4)。通过系统文献回顾分析了微创Reverdin-Isham 截骨术的结果,随访时间至少为 6 个月。

结果

在跖骨楔骨组中,影像学结果在跖骨间角(p<0.001)、拇外翻角和远节掌骨关节角(p<0.05)方面明显更好。就临床结果而言,两种方法都提供了相似的改善。

结论

在轻度至中度拇外翻畸形矫正中,微创远端跖骨楔骨截骨术的影像学结果优于微创Reverdin-Isham 截骨术。微创Reverdin-Isham 截骨术无法充分矫正 IMA。

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