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一种改良的90度远端人字形跖骨截骨术治疗中度拇外翻畸形

A Modified 90-Degree Distal Chevron Metatarsal Osteotomy for Correcting Moderate Hallux Valgus Deformity.

作者信息

Kyung Min Gyu, Park Gil Young, Yang Hanbual, Lee Dong Yeon

机构信息

Department of Orthopedic Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea.

Department of Orthopedic Surgery, SNU Seoul Hospital, Seoul 07803, Republic of Korea.

出版信息

J Clin Med. 2023 Nov 2;12(21):6902. doi: 10.3390/jcm12216902.

Abstract

Various modifications of distal chevron metatarsal osteotomy (DCMO) have been introduced for correcting moderate hallux valgus deformity; however, the amount of correction may be limited, and complications, such as the recurrence of the deformity and avascular necrosis of the metatarsal head, have been a problem. This study aimed to present a modified 90-degree DCMO technique that overcomes the previously reported shortcomings and to report a successful short-term radiographic outcome. Sixty-eight consecutive patients who underwent the operation with our modified DCMO technique and twenty-two consecutive patients with the conventional DCMO technique (control group) were retrospectively analyzed. The radiographic measurements were evaluated preoperatively, at two months post operation, and at the final follow-up. Both groups showed a significant correction of the hallux valgus angle, first-second intermetatarsal angle, distal metatarsal articular angle, and sesamoid position at the final follow-up, while the amount of correction was significantly greater in the modified DCMO group. In both groups, there were no cases of complications such as avascular necrosis of the metatarsal head, nonunion, and surgical site infection appearing throughout the follow-up period. Therefore, the modified 90-degree DCMO technique is effective and safe, which could serve as a favorable option to treat moderate hallux valgus deformity.

摘要

为矫正中度拇外翻畸形,人们引入了多种远端V形截骨术(DCMO)的改良术式;然而,矫正程度可能有限,而且诸如畸形复发和跖骨头缺血性坏死等并发症一直是个问题。本研究旨在介绍一种改良的90度DCMO技术,该技术克服了先前报道的缺点,并报告其成功的短期影像学结果。对连续68例行改良DCMO技术手术的患者和连续22例行传统DCMO技术手术的患者(对照组)进行回顾性分析。在术前、术后两个月及最终随访时对影像学测量指标进行评估。两组在最终随访时拇外翻角、第一-二跖骨间角、远端跖骨关节角和籽骨位置均有显著矫正,而改良DCMO组的矫正量显著更大。两组在整个随访期间均未出现跖骨头缺血性坏死、骨不连和手术部位感染等并发症。因此,改良的90度DCMO技术有效且安全,可作为治疗中度拇外翻畸形的良好选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e076/10648121/c1b3d1fc8071/jcm-12-06902-g001a.jpg

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