Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.
Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL.
J Foot Ankle Surg. 2023 Jul-Aug;62(4):683-688. doi: 10.1053/j.jfas.2023.02.008. Epub 2023 Feb 18.
Few prior studies have compared the patient reported outcomes of first metatarsophalangeal arthrodesis between hallux rigidus and hallux valgus patients. Furthermore, we sought to examine the impact of postoperative radiographic hallux alignment on outcomes scores within each group. A retrospective review of 98 patients who a received primary metatarsophalangeal arthrodesis from January 2010 to March 2020. Clinical complications including nonunion were collected. Patient Reported Outcomes Measurement Information Systems (PROMIS) Physical Function, PROMIS Pain Interference, and the foot function index (FFI) revised short form scores were obtained via telephone. Patients were grouped based on review of preoperative radiographs of the foot and this grouping 37 hallux rigidus and 61 hallux valgus patients. Clinical and patient reported outcomes were compared between these pathologies. No differences in the rate of wound complications, radiographic union, and revision surgery were found between the 2 subgroups. At a median of 2.4 years (3.9 IQR) postoperatively, PROMIS and FFI scores did not vary by pathology group. For both groups, PROMIS scores were similar to the general population of the United States. The postoperative first MTP dorsiflexion angle in the hallux rigidus group was correlated with decreased FFI Pain, FFI Total, and PROMIS Pain Interference domain scores (|r| ≥ 0.40, p < .05 for all). When performing MTP arthrodesis in patients with hallux rigidus, increasing the first MTP dorsiflexion angle may correlate with improved intermediate term patient reported outcomes. However, further studies will need to be done to confirm this theoretical relationship.
先前的研究很少比较僵硬拇和拇外翻患者的第一跖趾关节融合术后的患者报告结局。此外，我们还试图检查每组中术后放射学拇趾对线对结局评分的影响。回顾性分析了 2010 年 1 月至 2020 年 3 月期间接受初次跖趾关节融合术的 98 例患者。收集了包括骨折不愈合在内的临床并发症。通过电话获得了患者报告的结局测量信息系统（PROMIS）物理功能、PROMIS 疼痛干扰和足部功能指数（FFI）修订短表单评分。根据足部术前 X 光片的检查对患者进行分组，将 37 例僵硬拇和 61 例拇外翻患者分为两组。比较了这两种病理类型之间的临床和患者报告的结局。两组之间的伤口并发症、放射学愈合和翻修手术的发生率没有差异。术后中位数为 2.4 年（3.9 IQR），PROMIS 和 FFI 评分与病理分组无关。对于两组，PROMIS 评分与美国普通人群相似。僵硬拇组术后第一跖趾背屈角与 FFI 疼痛、FFI 总分和 PROMIS 疼痛干扰域评分降低相关（|r|≥0.40，所有 p<0.05）。在僵硬拇患者中进行 MTP 融合术时，增加第一跖趾背屈角可能与改善中期患者报告结局相关。然而，需要进一步的研究来证实这种理论关系。
