Xie Zhe, Wang Zhaona, Zhai Shan, Wu Jianzhong, Zhang Lixing, Gao Yanbing, Wu Hailong
Department of Orthopaedics (Fang Bei), Shijiazhuang People's Hospital, China.
Outpatient Operating Room, Shijiazhuang People's Hospital, China.
Medicine (Baltimore). 2025 Feb 14;104(7):e41251. doi: 10.1097/MD.0000000000041251.
To explore the application efficacy and safety of different osteotomy schemes in the repair and treatment of moderate to severe hallux valgus deformities. A sum of 117 patients with moderate to severe acute hallux valgus who underwent treatment at our hospital from April 2020 to April 2022 were selected. The envelope method was used to group the patients. The control group (n = 58) underwent double-plane osteotomy of the first metatarsal bone, while the observation group (n = 59) underwent Scarf osteotomy. The clinical efficacy of the 2 groups was compared, the differences in imaging results between the 2 groups at 6 months after surgery were analyzed, and the occurrence of complications during the follow-up period was observed. The excellent rate of the study group patients was 83.05% (49/59), which was compared to that of the control group (81.03%, 47/58) (P > .05). In comparison to the control group patients, the pain, force line, and joint function scores of the study group were compared before surgery and at 3 months after surgery (P > .05). Compared to before surgery, the pain, force line, joint function scores, The American Orthopaedic Foot & Ankle Society (AOFAS) total score, and Berg Balance Scale (BBS) score of the patients in both groups increased at 3 months after surgery. Additionally, the AOFAS total score and BBS score of the study group patients were higher than those of the control group patients (P < .05). The visual analog scale (VAS) scores of the patients in the 2 groups were compared before surgery (P > .05). The VAS scores of the study group patients were higher than those of the control group patients at 1, 2, and 3 months after surgery (P < .05). The study group patients were compared with the control group patients in terms of the hallux valgus angle, the lengths of the first and second metatarsals, the angle between the first and second metatarsals, the angle of the metatarsophalangeal joint surface, the position of the sesamoids, and the shortening length of the first metatarsal (P > .05). The Scarf osteotomy has shown advantages in postoperative gait balance and functional scoring. Therefore, when choosing an osteotomy plan, the Scarf osteotomy can be given priority to enhance the patient's balance ability and enhance their postoperative quality of life.
探讨不同截骨方案在中重度拇外翻畸形修复治疗中的应用效果及安全性。选取2020年4月至2022年4月在我院接受治疗的117例中重度急性拇外翻患者。采用信封法对患者进行分组。对照组（n = 58）行第一跖骨双平面截骨术，观察组（n = 59）行Scarf截骨术。比较两组的临床疗效，分析术后6个月两组影像学结果的差异，并观察随访期间并发症的发生情况。研究组患者的优良率为83.05%（49/59），与对照组（81.03%，47/58）比较，差异无统计学意义（P > 0.05）。比较研究组与对照组患者术前及术后3个月的疼痛、力线、关节功能评分（P > 0.05）。与术前比较，两组患者术后3个月的疼痛、力线、关节功能评分、美国矫形足踝协会（AOFAS）总分及伯格平衡量表（BBS）评分均升高。此外，研究组患者的AOFAS总分及BBS评分高于对照组患者（P < 0.05）。比较两组患者术前的视觉模拟评分（VAS）（P > 0.05）。研究组患者术后1、2、3个月的VAS评分高于对照组患者（P < 0.05）。比较研究组与对照组患者的拇外翻角度、第一和第二跖骨长度、第一和第二跖骨间角度、跖趾关节面角度、籽骨位置及第一跖骨缩短长度（P > 0.05）。Scarf截骨术在术后步态平衡和功能评分方面显示出优势。因此，在选择截骨方案时，可优先考虑Scarf截骨术，以提高患者的平衡能力，提升其术后生活质量。
