Department of Foot and Ankle Surgery, Center for Orthopaedic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
Orthop Surg. 2024 Dec;16(12):2984-2994. doi: 10.1111/os.14237. Epub 2024 Sep 18.
Few studies have explored the relationship between the pathological characteristics of hallux valgus and surgical outcomes. The aim of our study was to report the influence of pathological characteristics such as the tibial sesamoid position (TSP) and first metatarsal pronation on postoperative functional scores and patient satisfaction with hallux valgus surgery.
From June 2017 to December 2022, a retrospective analysis was conducted on patients who underwent hallux valgus surgery at our hospital. Anteroposterior (AP) x-ray parameters (hallux valgus angle [HVA], intermetatarsal angle [IMA], distal metatarsal articular angle [DMAA], TSP, first metatarsal pronation, and first metatarsophalangeal joint dislocation) (preoperative weight-bearing, immediate postoperative non-weight-bearing, and early postoperative weight-bearing), visual analog scale (VAS) scores, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores, SAFE-Q self-administered foot evaluation questionnaire (excluding the Sports Activity subscale), complications, and patient satisfaction were used to describe the outcomes. Correlation analysis and multiple linear regression models were used to identify factors influencing postoperative functional scores and patient satisfaction after hallux valgus surgery.
Eighty-one patients (92 feet) whose early radiographic parameters and latest follow-up scores improved significantly (p < 0.01) were included in the present study. The overall complication rate was 27.2%, with recurrence being the most common complication (20.7%). Functional scores and patient satisfaction were associated with age; preoperative, immediate postoperative, and early postoperative HVA; and immediate postoperative IMA (p < 0.05), but not with TSP, first metatarsal pronation, DMAA, callosities, toe deformities, or first metatarsophalangeal joint dislocation (p > 0.05). The R values of the multiple linear regression models predicting postoperative functional scores and patient satisfaction ranged from 0.042 to 0.351.
TSP and first metatarsal pronation were unrelated to postoperative functional scores or patient satisfaction. This finding enhances surgeons' understanding of the functional prognosis of hallux valgus surgery, particularly aiding in explaining the condition and assessing surgical outcomes.
鲜有研究探讨拇外翻的病理特征与手术结果之间的关系。本研究旨在报告诸如籽骨位置（TSP）和第一跖骨内翻等病理特征对拇外翻手术后功能评分和患者满意度的影响。
回顾性分析 2017 年 6 月至 2022 年 12 月在我院行拇外翻手术的患者。记录术前、即刻非负重位、早期负重位的影像学参数（拇外翻角[HVA]、跖骨间角[IMA]、远节跖骨关节角[DMAA]、TSP、第一跖骨内翻和第一跖趾关节脱位），视觉模拟评分（VAS）、美国矫形足踝协会（AOFAS）前足评分、SAFE-Q 自我评估足部问卷（不包括运动活动亚量表）、并发症和患者满意度，以评估手术结果。采用相关性分析和多元线性回归模型来确定影响拇外翻手术后功能评分和患者满意度的因素。
本研究共纳入 81 例（92 足）患者，其早期影像学参数和最新随访评分均有显著改善（p<0.01）。总体并发症发生率为 27.2%，其中复发最为常见（20.7%）。功能评分和患者满意度与年龄、术前、即刻术后和早期术后 HVA 以及即刻术后 IMA 相关（p<0.05），但与 TSP、第一跖骨内翻、DMAA、胼胝、趾畸形或第一跖趾关节脱位无关（p>0.05）。预测术后功能评分和患者满意度的多元线性回归模型的 R ² 值范围为 0.042 至 0.351。
TSP 和第一跖骨内翻与术后功能评分或患者满意度无关。这一发现加深了外科医生对拇外翻手术功能预后的理解，特别是有助于解释病情和评估手术结果。
