Biz Carlo, Bragazzi Nicola Luigi, Di Rita Anna, Pozzuoli Assunta, Belluzzi Elisa, Rodà Maria Grazia, Ruggieri Pietro
Department of Orthopedics and Orthopedic Oncology, Department of Surgery, Oncology and Gastroenterology DiSCOG, University-Hospital of Padova, Via Giustiniani 3, Padova, 35128, Italy.
Centre for Mechanics of Biological Materials, University of Padova, Padova, 35131, Italy.
J Orthop Surg Res. 2025 Feb 20;20(1):185. doi: 10.1186/s13018-025-05569-7.
Hallux valgus (HV) is a widespread condition that leads to discomfort in daily life. There are different surgical techniques for HV. This retrospective and comparative study aimed to compare the clinical and radiographic outcomes of the Reverdin-Isham osteotomy (RIO) and the Minimally Invasive Intramedullary Nail Device (MIIND) surgical techniques.
One hundred ninety-six patients with mild-to-severe HV were enrolled and divided into two groups: 98 patients with mild-moderate HV and 98 with moderate-severe HV, treated with the RIO and MIIND techniques, respectively. Radiographic and clinical evaluations were assessed preoperatively at 3, 12 and 60 months after surgery. Radiologically, the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), Distal Metatarsal Articular Angle (DMAA) and Tibial Sesamoid Position (TSP) were evaluated. Clinically, the AOFAS hallux metatarsophalangeal-interphalangeal scale and the Numeric Rating Scale (NRS-11) for pain were assessed. A propensity score matching (PSM) model was implemented to compare the two techniques.
In the RIO group, the mean HVA correction from preoperative value to 60 months of follow-up was 8.69° (p < 0.0001), the mean IMA correction was 2.42° (p < 0.0001), and the mean DMAA correction was 0.09°. In the MIIND group, the mean HVA correction was 24.92° (p < 0.0001), the mean IMA correction was 8.75° (p < 0.0001), and the mean DMAA correction was 6.28° (p < 0.0001). The mean AOFAS score improved over time, and NRS-11 decreased in both groups. After PSM model application, the variables that impacted the allocation to RIO or MIIND techniques were age, preoperative HVA values and HV severity.
Our study demonstrates the efficacy of RIO for mild-moderate HV and MIIND for moderate-severe HV. Radiographic and clinical outcomes improved in both groups, but older patients with higher HVA and severe HV should be treated with the MIIND technique to achieve satisfactory outcomes.
III, retrospective cohort study.
拇外翻（HV）是一种常见病症，会导致日常生活中的不适。针对HV有不同的手术技术。本回顾性比较研究旨在比较Reverdin-Isham截骨术（RIO）和微创髓内钉装置（MIIND）手术技术的临床和影像学结果。
纳入196例轻至重度HV患者，分为两组：98例轻中度HV患者和98例中重度HV患者，分别采用RIO和MIIND技术治疗。在术前、术后3个月、12个月和60个月进行影像学和临床评估。影像学上，评估拇外翻角（HVA）、跖间角（IMA）、跖骨头远端关节角（DMAA）和胫骨籽骨位置（TSP）。临床上，评估美国足踝外科协会（AOFAS）拇趾跖趾关节-趾间关节评分以及疼痛数字评定量表（NRS-11）。采用倾向评分匹配（PSM）模型比较两种技术。
在RIO组，从术前值到随访60个月时，平均HVA矫正为8.69°（p < 0.0001），平均IMA矫正为2.42°（p < 0.0001），平均DMAA矫正为0.09°。在MIIND组，平均HVA矫正为24.92°（p < 0.0001），平均IMA矫正为8.75°（p < 0.0001），平均DMAA矫正为6.28°（p < 0.0001）。两组的平均AOFAS评分随时间改善，NRS-11降低。应用PSM模型后，影响分配到RIO或MIIND技术的变量为年龄、术前HVA值和HV严重程度。
我们的研究证明了RIO对轻中度HV有效，MIIND对中重度HV有效。两组的影像学和临床结果均有改善，但年龄较大、HVA较高和严重HV的患者应采用MIIND技术治疗以获得满意结果。
III级，回顾性队列研究。
