采用 Internal Hallux Fixator®微创矫正踇外翻-尸体比较研究。
Minimally invasive hallux valgus correction with Internal Hallux Fixator® - A comparative cadaver study.
机构信息
Department of Orthopaedics and Traumatology, Martin Luther University Halle Wittenberg, Ernst-Grube-Strasse 40, 06120 Halle (Saale), Germany.
Department of Orthopaedics and Traumatology, Martin Luther University Halle Wittenberg, Ernst-Grube-Strasse 40, 06120 Halle (Saale), Germany.
出版信息
Foot Ankle Surg. 2022 Apr;28(3):378-383. doi: 10.1016/j.fas.2021.05.002. Epub 2021 Jul 3.
BACKGROUND
The Internal Hallux Fixator® (IHF®; Waldemar Link, Hamburg, Germany) was designed for open surgical hallux valgus correction. It allows a defined lateralisation of the first metatarsal head after V-shaped, Chevron-like distal metatarsal osteotomy in order to correct mild to middle hallux valgus deformities. The intramedullary fixation provides dynamic compression of the osteotomy and thus postoperative full weight bearing mobilization is an integral part of the therapy. This comparative cadaver model study investigates the feasibility of implanting the device using a minimally invasive technique and compares its capability of first metatarsal head lateralisation to the established 3rd generation MICA (Minimally Invasive Chevron and Akin osteotomy) technique.
METHODS
16 fresh frozen cadaveric feet (8 left, 8 right) of 8 body donors received either MICA (Group 1), or an IHF® in a minimally invasive technique (Group 2). The achievable first metatarsal head lateralisation and operating time were measured and pitfalls recorded.
RESULTS
This cadaver model study confirmed, the minimally invasive implantation of the Internal Hallux Fixator® can be performed reliably via 10 mm mini incision with V-shaped distal metatarsal osteotomy. The mean first metatarsal head lateralisation was comparable between the groups with no statistically significant difference (7.2 (±1.9) mm in G1, or 8.3 (±0.8) mm in G2; p = 0.09). The IHF® was inserted and fixed in mean 3.7 (±0.6) min, whereas double screw fixation needed 10 (±3.7) min.
LEVEL OF CLINICAL EVIDENCE
5, Cadaver model study.
背景
Internal Hallux Fixator®（IHF®；德国汉堡 Waldemar Link 公司）是为开放式外科拇外翻矫正而设计的。它允许在 V 形、类似 Chevron 的远端跖骨切开术后对第一跖骨头进行明确的外侧化，以矫正轻度至中度拇外翻畸形。髓内固定提供了截骨的动态压缩，因此术后完全负重活动是治疗的一个组成部分。这项比较尸体模型研究调查了使用微创技术植入该设备的可行性，并比较了其将第一跖骨头外侧化的能力与已建立的第 3 代 MICA（微创 Chevron 和 Akin 截骨术）技术的能力。
方法
8 名尸体供体的 16 只新鲜冷冻尸体脚（8 只左脚，8 只右脚）分别接受 MICA（第 1 组）或微创技术的 IHF®（第 2 组）治疗。测量了可实现的第一跖骨头外侧化和手术时间，并记录了操作中的困难。
结果
这项尸体模型研究证实，通过 V 形远端跖骨切开术，微创植入 Internal Hallux Fixator®是可靠的。两组之间的第一跖骨头外侧化平均差异无统计学意义（第 1 组为 7.2（±1.9）mm，第 2 组为 8.3（±0.8）mm；p=0.09）。IHF®平均插入和固定用时 3.7（±0.6）分钟，而双螺钉固定需要 10（±3.7）分钟。
临床证据水平
5，尸体模型研究。
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