Orthopedic Department, Sykehuset i Østfold Kalnes (Østfold Hospital Trust), Grålum, Norway.
Foot Ankle Spec. 2024 Feb;17(1_suppl):63S-67S. doi: 10.1177/19386400221131910. Epub 2022 Oct 26.
Metatarsal pronation is present in 87% of patients with hallux valgus (HV) deformity. The chevron osteotomy is commonly used worldwide to correct mild to moderate HV deformities. Many modifications have been described, but few address the rotational deformity of the first metatarsal. The rotational biplanar chevron osteotomy (RBCO), described by M. Prado et al, presents a variation of a biplanar chevron osteotomy that can be used to address first metatarsal rotation. The objective of this study is to investigate and verify the technique of the RBCO.
We conducted our study performing an RBCO on 9 cadaveric limbs. The technique uses a medial-based wedge parallel to the plantar limb of the osteotomy to make the distal fragment free to correct rotation. A goniometer was used by 2 individual surgeons to control the rotational correction achieved.
The osteotomy was considered simple to perform and we experienced no complications, such as fractures or instability. The result was satisfactory alignment and adequate stability. On average, a 2 mm wedge resulted in 11° of rotational correction.
We predict that RBCO can safely be used for correcting the metatarsal rotation when necessary in mild to moderate HV deformity foot.
Level IV.
在拇外翻(HV)畸形患者中,87%存在跖骨内翻。跖骨楔形骨切开术被广泛用于矫正轻度至中度 HV 畸形。已经描述了许多改良方法,但很少能解决第一跖骨的旋转畸形。由 M. Prado 等人描述的旋转双平面跖骨楔形骨切开术(RBCO)是一种双平面跖骨楔形骨切开术的变体,可用于解决第一跖骨旋转问题。本研究的目的是研究和验证 RBCO 的技术。
我们在 9 个尸体肢体上进行了 RBCO。该技术使用与骨切开术的足底支平行的基于内侧的楔形来使远端片段自由以纠正旋转。2 名外科医生使用量角器来控制所达到的旋转矫正。
该手术被认为易于进行,且我们未经历任何并发症,如骨折或不稳定。结果是满意的对线和足够的稳定性。平均而言,2 毫米的楔形可产生 11°的旋转矫正。
我们预测,在轻度至中度 HV 畸形足中,当需要纠正跖骨旋转时,RBCO 可以安全使用。
IV 级。