Ferreira Gabriel Ferraz, Mattos E Dinato Mauro Cesar, Santos Tatiana Ferreira Dos, Miziara Paulo, Pereira Miguel Viana
. Prevent Senior, Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, São Paulo, Brazil.
. Instituto Vita, São Paulo, Brazil.
Acta Ortop Bras. 2023 Jun 9;31(spe2):e265206. doi: 10.1590/1413-785220233102e265206. eCollection 2023.
Pronation of the first metatarsal in hallux valgus has recently been discussed among foot and ankle surgeons. This study aimed to evaluate the potential radiographic correction of moderate and severe hallux valgus using the percutaneous Chevron and Akin (PECA) technique.
We evaluated 45 feet in 38 patients (mean age 65.3 years old [36 - 83]; 4 men; 34 women; 7 bilateral) who underwent surgical correction using the PECA technique. The radiographic images evaluated were anteroposterior radiographs obtained pre- and postoperatively at least 6 months after surgery, including the metatarsophalangeal angle, the intermetatarsal angle, pronation of the first metatarsal, displacement of the distal fragment, medial sesamoid position and bone union.
All parameters evaluated showed significant postoperative improvement, including correction of pronation of the first metatarsal (p < .05) and position of the sesamoid (p < .05). There was a union of osteotomies in all feet. No complications were observed, such as screw loosening or necrosis of the first metatarsal head.
The PECA technique can correct pronation of the first metatarsal in moderate and severe hallux valgus, and other deformity-associated parameters. Level of Evidence IV; Case Series.
拇外翻中第一跖骨的旋前问题近来在足踝外科医生中受到了讨论。本研究旨在评估采用经皮Chevron截骨术和Akin截骨术（PECA技术）对中重度拇外翻进行潜在的影像学矫正效果。
我们评估了38例患者（平均年龄65.3岁[36 - 83岁]；4例男性；34例女性；7例双侧病变）的45只脚，这些患者均接受了PECA技术的手术矫正。所评估的影像学图像为术后至少6个月时获得的术前和术后前后位X线片，包括跖趾角、跖间角、第一跖骨的旋前、远侧骨折块移位、内侧籽骨位置及骨愈合情况。
所有评估参数术后均有显著改善，包括第一跖骨旋前（p < .05）及籽骨位置（p < .05）的矫正。所有足部截骨处均愈合。未观察到诸如螺钉松动或第一跖骨头坏死等并发症。
PECA技术可矫正中重度拇外翻中第一跖骨的旋前及其他与畸形相关参数。证据等级IV；病例系列。
