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比较经皮切骨术与开放性切骨术联合莫伯格截骨术治疗僵硬性拇趾的临床疗效。

Comparing the Clinical Outcomes of Percutaneous Cheilectomy to Open Cheilectomy With Moberg Osteotomy for the Treatment of Hallux Rigidus.

作者信息

DiGiovanni Grace M, El Masry Seif, Mizher Rami, Jones Agnes, Johnson A Holly, Ellis Scott J, Conti Matthew S

机构信息

Department of Foot and Ankle Surgery, The Hospital for Special Surgery, New York, NY, USA.

出版信息

Foot Ankle Orthop. 2024 Sep 3;9(3):24730114241264557. doi: 10.1177/24730114241264557. eCollection 2024 Jul.

Abstract

BACKGROUND

Both an open cheilectomy with a Moberg osteotomy and percutaneous cheilectomy have been successfully used to treat hallux rigidus and preserve motion.However, there have been no studies that have compared these 2 procedures using validated patient-reported outcomes such as the Patient Reported Outcome Measurement Information System.

METHODS

A retrospective review of hallux rigidus patients between January 2016 and July 2021 collected 48 percutaneous cheilectomy (PC) patients and 71 open cheilectomy with Moberg (OCM) patients. Preoperative and minimum 1-year postoperative PROMIS scores were collected.

RESULTS

The OCM and PC cohorts did not have significant differences in their postoperative PROMIS scores. Both cohorts had modest but significant improvements postoperatively in the physical function, pain interference, and pain intensity domains. The OCM group had a larger degree of improvement in physical function, pain interference, and pain intensity ( = .015, .011, .001, respectively). No significant difference was identified in the reoperation rate.

CONCLUSION

Patients undergoing an OCM had worse preoperative PROMIS scores and a modestly greater change in patient-reported outcomes than patients undergoing a PC.

LEVEL OF EVIDENCE

Level III, retrospective review.

摘要

背景

开放性拇趾关节切除术联合莫伯格截骨术和经皮拇趾关节切除术均已成功用于治疗僵硬性拇趾,并保留关节活动度。然而,尚无研究使用经过验证的患者报告结局,如患者报告结局测量信息系统,对这两种手术进行比较。

方法

对2016年1月至2021年7月期间的僵硬性拇趾患者进行回顾性研究,收集了48例经皮拇趾关节切除术(PC)患者和71例开放性拇趾关节切除术联合莫伯格(OCM)患者。收集术前和术后至少1年的患者报告结局测量信息系统(PROMIS)评分。

结果

OCM组和PC组术后PROMIS评分无显著差异。两组术后在身体功能、疼痛干扰和疼痛强度领域均有适度但显著的改善。OCM组在身体功能、疼痛干扰和疼痛强度方面的改善程度更大(分别为P = 0.015、0.011、0.001)。再手术率无显著差异。

结论

与接受PC手术的患者相比,接受OCM手术的患者术前PROMIS评分更差,患者报告结局的变化略大。

证据水平

III级,回顾性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d77/11401145/d02a426f22f6/10.1177_24730114241264557-fig1.jpg

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