SNU Seoul Hospital, Seoul 03080, Korea.
Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Int J Environ Res Public Health. 2022 May 26;19(11):6487. doi: 10.3390/ijerph19116487.
A metatarsal osteotomy is known to have the effect of reduction of the sesamoid. However, the reduction of the sesamoid is not always completed by a metatarsal osteotomy alone. The purpose of this cadaver study was to show that the improved technique of a modified Akin proximal phalanx osteotomy (MPO) could be helpful for the reduction of the sesamoids in hallux valgus surgery. Ten feet of cadavers were used; the cadavers had hallux valgus on both feet. The first trial of two feet underwent only the MPO. The other eight feet underwent a proximal metatarsal chevron osteotomy and MPO simultaneously. The hallux valgus angle, intermetatarsal angle, Hardy's grade, and Smith's grade were measured. To predict possible complications, cadavers were dissected after surgery. In the feet that underwent an MPO only, the hallux valgus angle and sesamoid position were improved. In the feet that underwent an MPO and metatarsal osteotomy, the hallux valgus deformity was completely corrected, and the sesamoid position was improved. Overall, the hallux valgus angle and intermetatarsal angle improved from 30.6 to 8.4 degrees and from 11.2 to 4.1 degrees, respectively. The sesamoid position was reduced from 5.3 to 2.5 (Hardy) and from 1.7 to 0.7 (Smith). The MPO combined with the metatarsal osteotomy were helpful for reducing the sesamoids compared to the metatarsal osteotomy only.
跖骨骨切开术已知具有降低籽骨的效果。然而，籽骨的降低并不总是仅通过跖骨骨切开术完成。本尸体研究的目的是表明改良 Akin 近节趾骨骨切开术（MPO）的改进技术在拇外翻手术中有助于降低籽骨。使用了十只脚的尸体；尸体的双脚都有拇外翻。首先对两只脚进行了仅 MPO 的试验。另外八只脚同时进行了近端跖骨楔形骨切开术和 MPO。测量了拇外翻角、跖骨间角、Hardy 分级和 Smith 分级。为了预测可能的并发症，手术后对尸体进行了解剖。在仅接受 MPO 的脚部，拇外翻角和籽骨位置得到改善。在接受 MPO 和跖骨切开术的脚部，拇外翻畸形完全矫正，籽骨位置得到改善。总体而言，拇外翻角和跖骨间角分别从 30.6 度改善至 8.4 度和从 11.2 度改善至 4.1 度。籽骨位置从 5.3 减少到 2.5（Hardy）和从 1.7 减少到 0.7（Smith）。与仅跖骨切开术相比，MPO 联合跖骨切开术有助于降低籽骨。
