Vaida Justin, Ray Justin J, Shackleford Taylor L, DeCarbo William T, Hatch Daniel J, Dayton Paul, McAleer Jody P, Smith W Bret, Santrock Robert D
Department of Orthopaedics, West Virginia University, Morgantown, WV, USA.
St Clair Orthopedic Associates, Pittsburgh, PA, USA.
Foot Ankle Orthop. 2020 Aug 13;5(3):2473011420934804. doi: 10.1177/2473011420934804. eCollection 2020 Jul.
Foot width reduction is a desirable cosmetic and functional outcome for patients with hallux valgus. Triplanar first tarsometatarsal (TMT) arthrodesis could achieve this goal by 3-dimensional correction of the deformity. The aim of this study was to evaluate changes in bony and soft tissue width in patients undergoing triplanar first TMT arthrodesis.
After receiving Institutional Review Board approval, charts were retrospectively reviewed for patients undergoing triplanar first TMT arthrodesis for hallux valgus at 4 institutions between 2016 and 2019. Patients who underwent concomitant first metatarsal head osteotomies (eg, Silver or Chevron) or fifth metatarsal osteotomies were excluded. Preoperative and postoperative anteroposterior weightbearing radiographs were compared to evaluate for changes in bony and soft tissue width. One hundred forty-eight feet from 144 patients (48.1 ± 15.7 years, 92.5% female) met inclusion criteria.
Preoperative osseous foot width was 96.2 mm, compared to 85.8 mm postoperatively ( < .001). Preoperative soft tissue width was 106.6 mm, compared to 99.3 mm postoperatively ( < .001). Postoperatively, patients had an average 10.4 ± 4.0 mm reduction (10.8% reduction) in osseous width and average 7.3 ± 4.0 mm reduction (6.8% reduction) in soft tissue width.
Triplanar first TMT arthrodesis reduced both osseous and soft tissue foot width, providing a desirable cosmetic and functional outcome for patients with hallux valgus. Future studies are needed to determine if patient satisfaction and outcome measures correlate with reductions in foot width. : Level III, retrospective comparative study.
足宽减小对于拇外翻患者而言是理想的美容和功能改善结果。三平面第一跖跗关节（TMT）融合术可通过对畸形进行三维矫正来实现这一目标。本研究的目的是评估接受三平面第一跖跗关节融合术患者的骨组织和软组织宽度变化。
在获得机构审查委员会批准后，对2016年至2019年间在4家机构接受三平面第一跖跗关节融合术治疗拇外翻的患者病历进行回顾性分析。排除同期接受第一跖骨头截骨术（如Silver或Chevron截骨术）或第五跖骨截骨术的患者。比较术前和术后负重前后位X线片，以评估骨组织和软组织宽度的变化。144例患者的148只足（年龄48.1±15.7岁，92.5%为女性）符合纳入标准。
术前足部骨宽度为96.2mm，术后为85.8mm（P<0.001）。术前软组织宽度为106.6mm，术后为99.3mm（P<0.001）。术后患者骨宽度平均减小10.4±4.0mm（减小10.8%），软组织宽度平均减小7.3±4.0mm（减小6.8%）。
三平面第一跖跗关节融合术可减小足部骨组织和软组织宽度，为拇外翻患者提供理想的美容和功能改善结果。未来需要开展研究以确定患者满意度和结局指标是否与足宽减小相关。：III级，回顾性比较研究。
