Department of Orthopedics, Central Lisbon University Center, 8 Beneficiência Street, 1069-166 Lisbon, Portugal.
Department of Orthopedics, Central Lisbon University Center, 8 Beneficiência Street, 1069-166 Lisbon, Portugal.
Foot (Edinb). 2022 May;51:101891. doi: 10.1016/j.foot.2021.101891. Epub 2021 Dec 23.
Several osteotomies of the first metatarsal have been described for treatment of hallux valgus but chevron osteotomy is one of the most common and well-established procedure for treating this deformity. Although there is a trend towards considering bilateral surgery there is lack of publications addressing bilateral treatment in ambulatory units. The aim of this study is to analyze results of bilateral and unilateral distal chevron osteotomies associated with lateral soft tissue release as ambulatory procedures.
A retrospective review was made about the patients treated at our ambulatory unit over a period of five years. Initially, general information as patient's satisfaction's rate and return to normal activity's time and evaluation of standardized follow-up charts and records made by the surgeon were recorded. Secondly, the hallux metatarsophalangeal interphalangeal scale developed by the American Orthopedic Foot & Ankle Society was used.
A total of 194 patients with 230 feet operated were included in this study. We found 29 patients that didn't meet the inclusion criteria and were excluded. The unilateral group was composed by 139 feet and the bilateral group by 52 feet. The improvement between preoperative and discharge clinical and radiographic results was significant independently in both groups. A total of 14% of complications were found in our study, 19% in the unilateral group and 12% at the bilateral group. None of them required revision surgery.
Bilateral distal chevron osteotomies, associated with lateral soft tissue release, are safe and effective ambulatory procedures. It was found a satisfactory deformity correction in moderate HV. Both patients that underwent unilateral and bilateral procedures had similar clinical and radiological outcomes with no increase in complications or return to normal activity time. With this study it was demonstrated that bilateral chevron osteotomies can be performed as ambulatory procedures.
已经描述了几种第一跖骨的截骨术来治疗拇外翻，但 Chevron 截骨术是治疗这种畸形最常见和最成熟的手术之一。尽管有考虑双侧手术的趋势，但在门诊单位缺乏针对双侧治疗的出版物。本研究的目的是分析双侧和单侧远端 Chevron 截骨术联合外侧软组织松解作为门诊手术的结果。
对我们门诊单位在五年期间治疗的患者进行了回顾性研究。最初，记录了患者的一般信息，如患者满意度、恢复正常活动的时间以及评估由外科医生制定的标准化随访图表和记录。其次，使用美国矫形足部和踝关节协会开发的拇外翻跖趾关节间关节量表。
本研究共纳入 194 例患者的 230 只脚。我们发现 29 例患者不符合纳入标准并被排除在外。单侧组由 139 只脚组成，双侧组由 52 只脚组成。两组术前和出院时临床和影像学结果的改善均有显著差异。我们的研究发现总共有 14%的并发症，单侧组为 19%，双侧组为 12%。它们都不需要进行修正手术。
双侧远端 Chevron 截骨术联合外侧软组织松解是安全有效的门诊手术。在中度 HV 中发现了令人满意的畸形矫正。接受单侧和双侧手术的患者具有相似的临床和影像学结果，并发症或恢复正常活动时间没有增加。通过这项研究表明，双侧 Chevron 截骨术可以作为门诊手术进行。
