Belda-Donat Maria, Marti-Martinez Luis M, Lorca-Gutierrez Rubén, Naranjo-Ruiz Carmen, Chacón-Giráldez Fernando, Barrios Carlos
School of Doctorate, Valencia Catholic University "San Vicente Mártir", 46001 Valencia, Spain.
Behavioural and Health Sciences Department, Miguel Hernandez University, 03550 San Juan de Alicante, Spain.
J Clin Med. 2024 Sep 14;13(18):5468. doi: 10.3390/jcm13185468.
Reverdin-Isham osteotomy is effective in correcting moderate hallux valgus deformity but has certain limitations when correcting a deformity in the sagittal plane. This study aimed to evaluate the impact on pain, functionality, and radiological measures of angular corrections, and the safety of the Reverdin-Isham lateral translation technique through minimally invasive surgery in the treatment of a moderate hallux valgus compared to Reverdin-Isham standard osteotomy. A pilot 6-month prospective cohort study was conducted on adults over 18 years old with a hallux valgus in at least one foot. The study exposure was the use of the Reverdin-Isham lateral translation technique. The outcome variables were pain and functionality through VAS and AOFAS scales, respectively, and radiological measurements of the first toe metatarsophalangeal angle (MPA), first space intermetatarsal angle (IMA), proximal articular set angle (PASA), distal articular set angle (DASA), metatarsal formula, and position of sesamoids in the AP projection. The study involved 60 participants. Results indicate significant reductions in pain and radiological measures in both cohorts: MPA improved by 23.13 degrees, IMA by 5.93 degrees, and sesamoid position by 4.23 degrees in patients who underwent the lateral translation technique versus 13.20, 3.30, and 1.57 degrees, respectively, in patients who experienced the standard Reverdin-Isham technique. The lateral translation method showed greater reductions in these metrics compared to the standard Reverdin-Isham technique ( < 0.05). Percutaneous Reverdin-Isham techniques, both standard and with lateral translations, effectively corrected moderate hallux valguses. However, the lateral translation method provided greater reductions in MPA, IMA, and sesamoid positions, making it more suitable for deformities with IMAs over 15 degrees.
雷维尔丹-伊沙姆截骨术在矫正中度拇外翻畸形方面有效,但在矫正矢状面畸形时存在一定局限性。本研究旨在评估与雷维尔丹-伊沙姆标准截骨术相比,雷维尔丹-伊沙姆外侧平移技术通过微创手术治疗中度拇外翻对疼痛、功能以及角度矫正的影像学指标的影响,以及该技术的安全性。对至少一只脚患有拇外翻的18岁以上成年人进行了一项为期6个月的前瞻性队列试验研究。研究暴露因素为使用雷维尔丹-伊沙姆外侧平移技术。结局变量分别为通过视觉模拟评分法(VAS)和美国足踝外科协会(AOFAS)评分量表评估的疼痛和功能,以及第一跖趾关节角(MPA)、第一跖骨间角(IMA)、近端关节固定角(PASA)、远端关节固定角(DASA)、跖骨公式和籽骨在前后位投照中的位置的影像学测量。该研究纳入了60名参与者。结果表明,两个队列的疼痛和影像学指标均显著降低:接受外侧平移技术的患者MPA改善了23.13度,IMA改善了5.93度,籽骨位置改善了4.23度;而接受标准雷维尔丹-伊沙姆技术的患者MPA、IMA和籽骨位置分别改善了13.20度、3.30度和1.57度。与标准雷维尔丹-伊沙姆技术相比,外侧平移方法在这些指标上的降低幅度更大(P<0.05)。经皮雷维尔丹-伊沙姆技术,无论是标准技术还是外侧平移技术,均能有效矫正中度拇外翻。然而,外侧平移方法在MPA、IMA和籽骨位置上的降低幅度更大,使其更适合IMA超过15度的畸形。