Su Po-Han, Lin Chung-Wei, Chiang Cheng-Hung, Wang Wei-Chih, Yeh Chen-Wei, Chen Hsien-Te, Fong Yi-Chin, Kuo Chien-Chung
Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, No. 2, Xueshi Rd., North Dist., Taichung City 404, Taiwan.
Department of Orthopedic Surgery, China Medical University Beigang Hospital, China Medical University, No. 123, Xinde Rd., Beigang Township, Yunlin County 651, Taiwan.
J Clin Med. 2024 Dec 13;13(24):7590. doi: 10.3390/jcm13247590.
: Hallux valgus is a common forefoot disorder with hundreds of proposed management techniques. Distal chevron osteotomy with a modified McBride procedure has been traditionally recommended for mild hallux valgus because of its simple and less invasive nature with fewer complications, faster recovery, and reliable outcomes. In recent years, the indications for this procedure have expanded to include hallux valgus with severe deformities. This study aims to compare the radiographic outcomes of the surgical treatment for moderate versus severe hallux valgus patients from the perspective of sesamoid bone reduction. : A retrospective review of medical records identified 99 feet from 94 patients that were treated with distal chevron osteotomy with a modified McBride procedure. These feet were divided by the preoperative hallux valgus angle and intermetatarsal angle into the moderate and severe groups. : Postoperative radiographic parameters significantly improved in both groups after treatment, indicating adequate deformity correction. Improvement in the sesamoid position was better in the moderate group compared to that in the severe group. The recurrence rate in the severe group was higher than that in the moderate group without statistical significance. : Based on the radiographic results of the postoperative position following sesamoid reduction, the distal chevron osteotomy with a modified McBride procedure is effective for treating moderate hallux valgus deformities. However, this treatment strategy may be associated with a higher recurrence rate in cases of severe hallux valgus deformity. A complete reduction in the sesamoids should be emphasized during the management of severe hallux valgus deformity.
拇外翻是一种常见的前足疾病，有数百种治疗方法。传统上，改良 McBride 手术联合远端 Chevron 截骨术因其操作简单、侵入性小、并发症少、恢复快且效果可靠，被推荐用于治疗轻度拇外翻。近年来，该手术的适应证已扩大至包括重度畸形的拇外翻。本研究旨在从籽骨复位的角度比较中度与重度拇外翻患者手术治疗的影像学结果。
对 94 例患者的 99 只脚进行回顾性病历审查，这些患者均接受了改良 McBride 手术联合远端 Chevron 截骨术治疗。根据术前拇外翻角和跖间角将这些脚分为中度和重度组。
治疗后两组的术后影像学参数均有显著改善，表明畸形矫正充分。中度组籽骨位置的改善优于重度组。重度组的复发率高于中度组，但无统计学意义。
根据籽骨复位后术后位置的影像学结果，改良 McBride 手术联合远端 Chevron 截骨术治疗中度拇外翻畸形有效。然而，对于重度拇外翻畸形，这种治疗策略可能与较高的复发率相关。在治疗重度拇外翻畸形时，应强调籽骨的完全复位。
