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: Hallux valgus is a common painful condition with tri-planar deformity of the first ray. Surgical correction consists of distal osteotomy of the first metatarsal and its lateral translation. However, in the case of hypermobility of the first cuneo-metatarsal joint (TMTJ), the associated Lapidus procedure is indicated to correct deformities along all three anatomical planes. Lapidus procedure is reported to have several contraindications and complications; for this reason, many surgeons proposed technical modification to the original procedure. We present the results of a novel surgical technique for hallux valgus correction with minimally invasive arthrodesis of first TMTJ without proximal correction of deformity, combined with a distal Austin-Chevron procedure. Materials and : We retrospectively evaluated patients who underwent surgical correction of hallux valgus with our technique between January 2010 and January 2020. We collected data on demographics, anesthesiologic technique, associated surgical procedures, post-operative functional results, and complications. Dorso-plantar and lateral radiographs were performed at 6, 12, and 24 weeks after surgery or until fusion was documented. Clinical assessment considered gait analysis, pain or other disturbance, type of shoes worn, and use of orthosis. : A total of 240 patients were enrolled. AOFAS score, hallux valgus angle, and inter-metatarsal angle showed a significant improvement. Complications consisted of distal osteotomy non-union (1%), pain or protrusion of the screw (13%), and recurrence of deformity (2%). Overall, patients were very satisfied with the surgery in 192/278 (69%) cases, moderately satisfied in 67/278 (24%) cases, satisfied in 8/278 (3%) cases, and dissatisfied in 11/278 (4%) cases. : Our novel surgical technique which combines in situ arthrodesis of the first tarso-metatarsal joint (TMTJ) with a distal Austin-Chevron procedure offers an effective alternative for correcting hallux valgus with first-ray hypermobility, minimizing complications associated with traditional methods.

拇外翻是一种常见的伴有第一跖骨三平面畸形的疼痛性疾病。手术矫正包括第一跖骨远端截骨及其外侧移位。然而，在第一楔骨 - 跖骨关节（TMTJ）活动度过高的情况下，需要进行相关的拉皮德斯手术来矫正所有三个解剖平面的畸形。据报道，拉皮德斯手术有多种禁忌症和并发症；因此，许多外科医生对原始手术提出了技术改进。我们展示了一种用于矫正拇外翻的新型手术技术的结果，该技术通过第一TMTJ的微创关节融合术且不进行近端畸形矫正，并结合远端奥斯汀 - 雪佛龙手术。

材料与方法

我们回顾性评估了2010年1月至2020年1月期间采用我们的技术接受拇外翻手术矫正的患者。我们收集了关于人口统计学、麻醉技术、相关手术操作、术后功能结果和并发症的数据。在术后6周、12周和24周或直至记录到融合时进行正侧位X线片检查。临床评估包括步态分析、疼痛或其他不适、所穿鞋子类型以及矫形器的使用情况。

结果

共纳入240例患者。美国足踝外科协会（AOFAS）评分、拇外翻角度和跖间角均有显著改善。并发症包括远端截骨不愈合（1%）、螺钉疼痛或突出（13%）以及畸形复发（2%）。总体而言，192/278（69%）例患者对手术非常满意，67/278（24%）例患者中度满意，8/278（3%）例患者满意，11/278（4%）例患者不满意。