Bayam Levent, Ryan Paul, Bilal Muhammad, Fayyaz Irfan, Drampalos Efstathios
Manchester Royal Infirmary Orthopaedic Department, Manchester, UK.
Orthopaedic Department, Forth Valley Royal Hospital, Larbert, Scotland, UK.
Indian J Orthop. 2022 Jan 16;56(5):895-901. doi: 10.1007/s43465-021-00572-6. eCollection 2022 May.
We describe a new surgical technique for arthrodesis of the first tarso-metatarsal (TMT) joint using an intraosseous fixation device and the early results including patient-reported outcome measures (PROMS).
Seventeen consecutive procedures with this method were included. Indication for surgery was hallux valgus. The average age was 42 years (range 26-65). PROMS were collected and the patients were asked to fill out a satisfaction questionnaire. A retrospective review of radiographs and electronic medical notes was conducted.
Overall fusion rate was 94%. Complications included a case of failed fusion, a superficial wound infection and a deep vein thrombosis (DVT). At a mean follow-up of 24 months (range 10-38) radiographic results demonstrated significant improvement in the intermetatarsal angle or IMA (11.7 ± 2.8 degrees to 6.9 ± 2.4 degrees, < 0.001) and hallux valgus angle or HVA (28.1 ± 7.3 degrees to 12.2 ± 4.3 degrees, < 0.001). The mean visual analog scale (VAS) score improved significantly from a mean of 7.6 (SD 0.85) preoperatively, to a mean of 2.1 (SD 1.83) post-operatively ( < 0.0001). The Manchester-Oxford Foot Questionnaire (MOXFQ) significantly improved from a mean of 35.8 (SD 10.2), to a mean of 9.2 (SD 17) ( < 0.0001). The final result was satisfactory for 88% of the patients.
The early results show intraosseous fixation to be a safe and efficient method for the fusion of the first TMT joint providing good patient satisfaction.
我们描述了一种使用骨内固定装置进行第一跖跗（TMT）关节融合的新手术技术以及早期结果，包括患者报告的结局指标（PROMS）。
纳入连续采用该方法进行的17例手术。手术指征为拇外翻。平均年龄为42岁（范围26 - 65岁）。收集PROMS并要求患者填写满意度问卷。对X线片和电子病历进行回顾性分析。
总体融合率为94%。并发症包括1例融合失败、1例表浅伤口感染和1例深静脉血栓形成（DVT）。平均随访24个月（范围10 - 38个月），X线结果显示跖间角（IMA）有显著改善（从11.7±2.8度改善至6.9±2.4度，P<0.001）以及拇外翻角（HVA）有显著改善（从28.1±7.3度改善至12.2±4.度，P<0.001）。视觉模拟量表（VAS）评分从术前平均7.6（标准差0.85）显著改善至术后平均2.1（标准差1.83）（P<0.0001）。曼彻斯特 - 牛津足部问卷（MOXFQ）从平均35.8（标准差10.2）显著改善至平均9.2（标准差17）（P<0.0001）。88%的患者对最终结果满意。
早期结果表明骨内固定是第一TMT关节融合的一种安全有效的方法，患者满意度良好。
