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裁缝拇囊炎的经皮手术:一项对比研究。

Percutaneous Surgery for Tailor's Bunion: A Comparative Study.

作者信息

Lara Luiz Carlos Ribeiro, Lancia Lara Furtado, Santos Diego Vitor Braga, Carvalho Matheus Maciel Dornelles de, Lima Frederico Pinheiro de, Arruda João Lucas Gonçalves

机构信息

Serviço de Ortopedia e Traumatologia, Hospital Municipal Universitário de Taubaté, Taubaté, SP, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2023 Dec 5;59(5):e730-e736. doi: 10.1055/s-0043-1776292. eCollection 2024 Oct.

Abstract

To analyze and compare the clinical and radiographic outcomes of bunionette correction using two percutaneous surgical techniques: the Sponsel technique and the medial wedge osteotomy of the distal metaphysis. The results were evaluated individually and comparatively using the American Orthopaedic Foot and Ankle Society's Lesser Metatarsophalangeal-Interphalangeal Scale (AOFAS), Visual Analog Scale (VAS) for pain assessment, and radiographic measurements of the intermetatarsal angle IV-V (AIM4-5) and metatarsophalangeal angle of the fifth ray (AMF-5).  This was a retrospective study conducted from May 2011 to February 2022. A total of 32 feet were operated on, with 12 feet undergoing the Sponsel technique and 20 feet undergoing the medial wedge osteotomy of the distal metaphysis of the fifth metatarsal.  Both surgical techniques showed significant improvement in the correction of AIM4-5 and AMF-5 angles (  < 0.001). However, there was no statistical significance when comparing the two techniques. In terms of AOFAS and VAS scores, both techniques yielded satisfactory results. Nevertheless, the medial wedge osteotomy demonstrated significantly better outcomes compared with the Sponsel technique (  < 0.001).  Both percutaneous techniques employed for bunionette correction resulted in significant improvement in radiographic angles and evaluated scores, with a low complication rate, making them viable options for treating this condition. When compared, the medial wedge osteotomy appeared to yield better clinical outcomes.

摘要

分析并比较两种经皮手术技术(斯庞塞尔技术和第五跖骨远端干骺端内侧楔形截骨术)矫正小趾囊炎畸形的临床和影像学结果。使用美国矫形足踝协会的小跖趾关节-趾间关节量表(AOFAS)、用于疼痛评估的视觉模拟量表(VAS)以及第四至第五跖骨间角(AIM4-5)和第五跖骨的跖趾关节角(AMF-5)的影像学测量结果对结果进行单独和比较评估。

这是一项于2011年5月至2022年2月进行的回顾性研究。共对32只脚进行了手术,其中12只脚采用斯庞塞尔技术,20只脚采用第五跖骨远端干骺端内侧楔形截骨术。

两种手术技术在矫正AIM4-5和AMF-5角度方面均显示出显著改善(P < 0.001)。然而,比较这两种技术时没有统计学意义。在AOFAS和VAS评分方面,两种技术均取得了满意的结果。尽管如此,与斯庞塞尔技术相比,内侧楔形截骨术的结果明显更好(P < 0.001)。

用于矫正小趾囊炎畸形的两种经皮技术均使影像学角度和评估评分得到显著改善,并发症发生率低,使其成为治疗该病症的可行选择。相比之下,内侧楔形截骨术似乎产生了更好的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bdc/11624943/8e0721d3f998/10-1055-s-0043-1776292-i2300010en-1.jpg

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