Novoshelski Shaun, Fazio Salvatore, Meyr Andrew J
Temple University Hospital Podiatric Surgical Residency Program, Philadelphia, PA, USA.
Department of Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA, USA.
J Foot Ankle Surg. 2025 Mar-Apr;64(2):208-211. doi: 10.1053/j.jfas.2024.10.006. Epub 2024 Oct 24.
The literature has established that the first metatarsal-phalangeal joint arthrodesis procedure will provide some correction of the first intermetatarsal and hallux valgus angles. But while this has previously primarily been investigated as a simple association (i.e. comparison of pre-operative to post-operative values), the objective of this investigation was to consider angular change as a continuous variable and to specifically correlate it with pre-operative values. Radiographs from 100 consecutive first metatarsal-phalangeal joint arthrodeses meeting selection criteria were evaluated. A negative Pearson correlation coefficient was observed between the pre-operative first intermetatarsal angle and intraoperative change in the first intermetatarsal angle (Pearson -0.547; p<0.001). In other words, with progressively increased levels of pre-operative intermetatarsal angle deformity, one should expect greater intermetatarsal angle correction. The relationship is described by the equation Y = 2.82 - 0.38X indicating that for every one degree of pre-operative intermetatarsal deformity over approximately 7 degrees, 0.38 degrees of post-operative correction might be expected. A negative Pearson correlation was observed between the pre-operative hallux valgus angle and the intraoperative change in the first hallux valgus angle (Pearson -0.806; p<0.001). In other words, with progressively increased levels of pre-operative hallux valgus angle deformity, one should expect greater hallux valgus correction. The relationship is described by the equation Y = 5.5 - 0.63X indicating that for every one degree of pre-operative hallux valgus angle deformity over approximately 9 degrees, 0.63 degrees of hallux valgus angle post-operative correction might be expected. Results of this investigation demonstrate a statistical correlation between pre-operative radiographic deformity and intermetatarsal angle and hallux valgus angle post-operative correction, and might provide foot and ankle surgeons with a degree pre-operative prediction of expected angular correction following the procedure.
文献表明，第一跖趾关节融合术可对第一跖间角和拇外翻角进行一定程度的矫正。但此前这主要作为一种简单关联进行研究（即术前与术后值的比较），本研究的目的是将角度变化视为连续变量，并具体将其与术前值相关联。对100例符合选择标准的连续第一跖趾关节融合术的X线片进行了评估。术前第一跖间角与术中第一跖间角变化之间观察到负的Pearson相关系数（Pearson -0.547；p<0.001）。换句话说，随着术前跖间角畸形程度的逐渐增加，预期的跖间角矫正程度会更大。这种关系由方程Y = 2.82 - 0.38X描述，表明术前跖间畸形每超过约7度1度，术后可能预期矫正0.38度。术前拇外翻角与术中第一拇外翻角变化之间观察到负的Pearson相关性（Pearson -0.806；p<0.001）。换句话说，随着术前拇外翻角畸形程度的逐渐增加，预期的拇外翻矫正程度会更大。这种关系由方程Y = 5.5 - 0.63X描述，表明术前拇外翻角畸形每超过约9度1度，术后拇外翻角可能预期矫正0.63度。本研究结果表明术前影像学畸形与术后跖间角和拇外翻角矫正之间存在统计学相关性，并可能为足踝外科医生提供该手术后预期角度矫正的术前预测程度。
