Uluöz Mesut, Gökmen Mehmet Yiğit, Pazarcı Özhan
Department of Orthopaedics and Traumatology, Adana City Training and Research Hospital, University of Health Sciences, Adana, Turkey.
J Orthop Surg Res. 2025 Jan 20;20(1):69. doi: 10.1186/s13018-024-05413-4.
The development of a cost-effective and easily applicable fixation method to address all components of hallux valgus (HV) surgery is of great importance to the field. This study aims to assess the clinical efficacy of an alternative fixation method that combines the advantages aspects of commonly used distal osteotomy techniques and evaluate its level of applicability in the treatment of mild and moderate HV cases.
The retrospectively designed study was conducted at Adana City Training and Research Hospital, Adana, Türkiye. The inclusion criteria were as follows: having undergone distal metatarsal osteotomy, minimum duration of follow-up of twelve months, and the availability of dorsoplantar weight-bearing X-ray images of the foot performed preoperatively and at the follow-up visits. The analysis data included age, gender, Visual Analog Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores, the values of the length of the 1st metatarsal, hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), rotation type of the first metatarsal (RTFM), and the position of the tibial sesamoid (TSP).
A total of 82 files were available for analysis. The mean age of the patients was 40.5 ± 13.8 (Median = 43) years; 67 (81,7%) were female, and 15 (18.3%) were male. The mean operation duration was 33.2 ± 3.0 min. The mean follow-up period was 22.7 ± 7.0 months. There was a linear relationship between the average age of the patients and the shortness (mm) values (r = 0.466; p < 0.001). The HVA, IMA, DMAA, TSP, and VAS scores were lower in the patients after the operation compared to before values (p < 0.001). The preoperative assessment of RTFM identified 15 cases with an angular type, 38 cases with an intermediate type, and 29 cases with a round type. The postoperative mean AOFAS value was higher than the mean score before the operation (p < 0.001). A dramatic reduction was observed in postoperative IMA and DMAA values (p < 0.001).
This study's findings demonstrate the benefits of a new fixation method for treating HV that is applicable to all mild and moderate HV cases. This method enables intraoperative readjustment without compromising the fixation strength and has a short learning curve.
开发一种经济高效且易于应用的固定方法来解决拇外翻（HV）手术的所有组成部分，对该领域至关重要。本研究旨在评估一种替代固定方法的临床疗效，该方法结合了常用远端截骨技术的优点，并评估其在治疗轻度和中度HV病例中的适用程度。
这项回顾性设计的研究在土耳其阿达纳市培训与研究医院进行。纳入标准如下：接受过远端跖骨截骨术，随访时间至少为十二个月，并且有术前和随访时足部的背跖位负重X线图像。分析数据包括年龄、性别、视觉模拟量表（VAS）和美国矫形足踝协会（AOFAS）评分、第一跖骨长度值、拇外翻角（HVA）、跖间角（IMA）、远端跖骨关节角（DMAA）、第一跖骨旋转类型（RTFM）以及胫骨籽骨位置（TSP）。
共有82份档案可供分析。患者的平均年龄为40.5±13.8（中位数=43）岁；67例（81.7%）为女性，15例（18.3%）为男性。平均手术时间为33.2±3.0分钟。平均随访期为22.7±7.0个月。患者的平均年龄与缩短（mm）值之间存在线性关系（r=0.466；p<0.001）。术后患者的HVA、IMA、DMAA、TSP和VAS评分均低于术前值（p<0.001）。术前对RTFM的评估确定15例为角型，38例为中间型，29例为圆型。术后平均AOFAS值高于术前平均评分（p<0.001）。术后IMA和DMAA值显著降低（p<0.001）。
本研究结果表明，一种用于治疗HV的新固定方法具有诸多益处，适用于所有轻度和中度HV病例。该方法能够在不影响固定强度的情况下进行术中调整，且学习曲线较短。
