改良Mitchell截骨术与Chevron截骨术治疗拇外翻的比较。
Comparison of modified Mitchell and Chevron osteotomies for hallux valgus.
作者信息
Kurtuluş Burhan, Çevik Hüseyin Bilgehan, Aydın Erbil
机构信息
University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
出版信息
Foot Ankle Surg. 2023 Apr;29(3):239-242. doi: 10.1016/j.fas.2023.01.012. Epub 2023 Jan 27.
BACKGROUND
Good clinical and radiological outcomes in mild-moderate hallux valgus (HV) can be achieved with Chevron osteotomy (CO) and modified-Mitchell osteotomy (MMO). The main goal of the present study was to compare the clinical and radiological outcomes after CO and MMO in HV.
METHODS
The study included 45 patients, comprising 40 females with a mean follow-up of 87.5 ± 27.8 months. The outcome measurements of metatarsal length (MT1), HV angle (HVA), intermetatarsal angle (IMA), clinical outcomes, and metatarsalgia were evaluated pre- and postoperatively.
RESULTS
No significant difference was determined between the MMO and CO groups in respect of metatarsalgia and AOFAS scores. The CO resulted in a significantly larger decrease in the MT1. The mean HVA and IMA correction was significantly greater after MMO than after CO.
CONCLUSION
Since MMO may prevent MT1 shortening, which is a typical problem in the Mitchell osteotomy, MMO may be preferred over CO in patients with preoperative shortened first metatarsal.
背景
采用契形截骨术（CO）和改良米切尔截骨术（MMO）可在轻中度拇外翻（HV）患者中取得良好的临床和影像学效果。本研究的主要目的是比较CO和MMO治疗HV后的临床和影像学效果。
方法
本研究纳入45例患者，其中40例女性，平均随访时间为87.5 ± 27.8个月。术前和术后评估第一跖骨长度（MT1）、拇外翻角（HVA）、跖间角（IMA）、临床效果和跖痛症等结果指标。
结果
MMO组和CO组在跖痛症和美国足踝外科协会（AOFAS）评分方面无显著差异。CO导致MT1显著缩短。MMO术后平均HVA和IMA矫正度显著大于CO术后。
结论
由于MMO可避免MT1缩短，而MT1缩短是米切尔截骨术的典型问题，因此对于术前第一跖骨缩短的患者，MMO可能比CO更具优势。
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