Department of Orthopaedics and Trauma Surgery, Havelland Clinic Nauen, Ketzinerstr. 21, 14641, Nauen, Germany.
Centre for Clinical Research, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin, Germany.
Eur J Orthop Surg Traumatol. 2024 Aug;34(6):3329-3337. doi: 10.1007/s00590-024-04074-7. Epub 2024 Aug 20.
Hallux valgus (HV) is the most common forefoot deformity. Surgical correction of HV aims to reduce pain, preserve joints, and re-establish foot function while restoring the hallux valgus angle (HVA) and intermetatarsal angle (IMA). Many surgical procedures have been proposed, including open and minimally invasive (MI) techniques. This study aimed to compare the midterm outcomes of open vs. MI procedures and their impact on the duration of surgery, hospital stay, HVA, and IMA post-operatively.
One hundred and twenty HV patients operated by open or MI surgery between October 2019 and October 2022 were included. One hundred three patients met the inclusion criteria and consented to the study. Patients were prospectively surveyed for foot functionality, post-operative pain, and complications using the AOFAS score. Radiographic measurements of HV angles, length of hospital stay, and surgery duration were analysed.
MI surgery patients had significantly better AOFAS scores (p < 0.001) 12 months post-operatively compared to open surgery. Complication rates were lower in the MI group (3.8% vs. 33.3%, p < 0.001). MI surgery patients also had shorter hospital stays (0.9 ± 0.3 days vs. 2.0 ± 0.0 days) and surgery duration (19.7 ± 2.3 min vs. 80.7 ± 6.8 min). MI surgery was more effective in correcting the IMA but equally effective as open surgery for HVA correction.
MI surgery resulted in better patient satisfaction, fewer complications, and more precise correction of IMA values. Moreover, the duration of surgery and hospital stay were significantly lower in patients undergoing MI surgery. Further research is needed to validate these findings in controlled, prospective randomised trials.
拇外翻（HV）是最常见的前足畸形。HV 的手术矫正旨在减轻疼痛、保护关节、重建足部功能，同时恢复拇外翻角（HVA）和跖骨间角（IMA）。已经提出了许多手术方法，包括开放式和微创（MI）技术。本研究旨在比较开放式和 MI 手术的中期结果及其对手术时间、住院时间、术后 HVA 和 IMA 的影响。
2019 年 10 月至 2022 年 10 月，我们对接受开放式或 MI 手术治疗的 120 例 HV 患者进行了研究。103 例患者符合纳入标准并同意参与研究。使用 AOFAS 评分对患者的足部功能、术后疼痛和并发症进行前瞻性调查。分析 HV 角度、住院时间和手术时间的放射学测量结果。
MI 手术组患者术后 12 个月的 AOFAS 评分明显优于开放式手术组（p<0.001）。MI 组的并发症发生率较低（3.8% vs. 33.3%，p<0.001）。MI 手术组的住院时间（0.9±0.3 天 vs. 2.0±0.0 天）和手术时间（19.7±2.3 分钟 vs. 80.7±6.8 分钟）也较短。MI 手术在矫正 IMA 方面更有效，但在矫正 HVA 方面与开放式手术同样有效。
MI 手术可提高患者满意度，减少并发症，更精确地矫正 IMA 值。此外，MI 手术组患者的手术时间和住院时间明显缩短。需要进一步的研究来验证这些发现，这些发现需要在对照、前瞻性随机试验中得到验证。
