Chong Hon Chun, Lui Tun Hing
Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, Hong Kong.
Arthrosc Tech. 2023 Jun 19;12(7):e1171-e1177. doi: 10.1016/j.eats.2023.03.006. eCollection 2023 Jul.
Arthrodesis of the first metatarsophalangeal joint is indicated for severe hallux valgus deformity. Open arthrodesis requires extensive soft-tissue dissection. Recently, a technique of arthroscopic first metatarsophalangeal arthrodesis in hallux valgus deformity has been reported. This approach includes endoscopic lateral release of the first metatarsophalangeal joint via the plantar and toe web portals, followed by arthroscopic arthrodesis of the joint via the medial and dorsolateral portals. Endoscopic lateral release of the first metatarsophalangeal joint can convert the fixed hallux valgus deformity into a flexible one and reduce the stress over the screws and risk of loss of reduction and nonunion. The purpose of this Technical Note is to report a modified technique of arthroscopic first metatarsophalangeal arthrodesis in hallux valgus deformity. In this modified technique, the arthrodesis is performed via the medial and toe web portals and creation of the dorsolateral portal is not needed. A 2.7-mm arthroscope is used for the arthrodesis procedure instead of a 1.9-mm arthroscope. This can improve fluid inflow and visualization.
第一跖趾关节融合术适用于严重拇外翻畸形。开放性融合术需要广泛的软组织解剖。最近，有报道一种用于拇外翻畸形的关节镜下第一跖趾关节融合技术。该方法包括通过足底和趾蹼入口进行第一跖趾关节的内镜下外侧松解，随后通过内侧和背外侧入口进行关节镜下关节融合。第一跖趾关节的内镜下外侧松解可将固定的拇外翻畸形转变为可弯曲畸形，并减少螺钉上的应力以及复位丢失和骨不连的风险。本技术说明的目的是报告一种用于拇外翻畸形的关节镜下第一跖趾关节融合改良技术。在这种改良技术中，融合通过内侧和趾蹼入口进行，不需要创建背外侧入口。关节融合手术使用2.7毫米关节镜而非1.9毫米关节镜。这可以改善液体流入和视野。
