Foot and Ankle Surgery Group, Orthopaedics and Traumatology Unit, Prevent Senior, São Paulo, Brazil.
Member of Minimally Invasive Foot Ankle Society (MIFAS), Merignac, France.
Arch Orthop Trauma Surg. 2023 Nov;143(11):6521-6526. doi: 10.1007/s00402-023-04948-1. Epub 2023 Jun 26.
Percutaneous metatarsophalangeal arthrodesis is an option for the treatment of hallux rigidus in more advanced cases. The aim of this study was to investigate the clinical and radiographic results at least 2 years after percutaneous metatarsophalangeal arthrodesis in patients with hallux rigidus.
This is a case series of consecutive patients undergoing percutaneous metatarsophalangeal arthrodesis in patients with hallux rigidus grades III and IV with a minimum of 24 months of clinical and radiographic follow-up. The primary outcome was clinical assessment using the Visual Analog Scale for Pain (VAS). Secondary outcomes included American Orthopedic Foot & Ankle Society (AOFAS) score, patient satisfaction, complications, and bone healing (radiographic analysis).
Between August 2017 and February 2020, 29 feet (24 patients) underwent percutaneous metatarsophalangeal arthrodesis. The mean follow-up was 38.4 (range 24-54) months. There was an improvement in the pain (VAS) from 7.8 to 0.6 (p < 0.001) and in the AOFAS score from 49.9 to 83.6 (p < 0.001). There was a rate of bone union of 82.8% and screw removal of 13.8%. All patients considered the result to be excellent or good.
The treatment of grade III and IV hallux rigidus with percutaneous metatarsophalangeal arthrodesis demonstrated high patient satisfaction and significantly improves in clinical outcomes but the nonunion rate was higher than reported outcomes for open 1st metatarsophalangeal joint arthrodesis.
IV, case series.
对于更严重的拇僵硬病例，经皮跖趾关节融合术是一种治疗选择。本研究旨在探讨至少 2 年后拇僵硬患者经皮跖趾关节融合术的临床和影像学结果。
这是一系列连续接受经皮跖趾关节融合术治疗的拇僵硬 III 级和 IV 级患者的病例系列研究，临床和影像学随访时间至少为 24 个月。主要结局是使用疼痛视觉模拟量表（VAS）进行临床评估。次要结局包括美国矫形足踝协会（AOFAS）评分、患者满意度、并发症和骨愈合（影像学分析）。
2017 年 8 月至 2020 年 2 月，29 足（24 例）接受经皮跖趾关节融合术。平均随访时间为 38.4（24-54）个月。疼痛（VAS）从 7.8 分改善至 0.6 分（p<0.001），AOFAS 评分从 49.9 分改善至 83.6 分（p<0.001）。骨愈合率为 82.8%，螺钉取出率为 13.8%。所有患者均认为结果为优或良。
经皮跖趾关节融合术治疗 III 级和 IV 级拇僵硬患者的满意度高，临床疗效显著改善，但不愈合率高于开放性第一跖趾关节融合术的报道。
IV，病例系列研究。
