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微创拇囊炎手术(MIBS)的多维系统评价

A Multi-Dimensional Systematic Review of Minimally Invasive Bunion Surgery (MIBS).

作者信息

Lonati Danielle, Kannegieter Ewan, McHugh Douglas

机构信息

Frank H. Netter MD School of Medicine, Department of Medical Sciences, Quinnipiac University, Hamden, CT 06518, USA.

Provide Health, Braintree Hospital, Braintree CM7 2AL, UK.

出版信息

J Clin Med. 2025 Apr 17;14(8):2757. doi: 10.3390/jcm14082757.

Abstract

: Hallux valgus, or a bunion, is a prevalent foot deformity associated with pain, limited mobility, and reduced quality of life. Surgical treatments include minimally invasive and traditional open techniques, but the optimal approach remains debated. This systematic review evaluates long-term outcomes, patient satisfaction, cost-effectiveness, the influence of patient-specific factors, rehabilitation protocols, and complication rates for these methods. : A comprehensive search of PubMed, Medline, EMBASE, and Cochrane databases identified 22 studies published within the last 15 years, each with a minimum follow-up of 2 years. The systematic review adhered to PRISMA-ScR guidelines. Eligible studies reported on at least one of six key outcomes, and data were extracted on radiographic and clinical results, patient satisfaction, costs, rehabilitation timelines, and adverse events. : Minimally invasive bunion surgery (MIBS) showed faster recovery, higher patient satisfaction, and improved quality of life compared to open surgery. Radiographic outcomes, including hallux valgus and intermetatarsal angle correction, were durable, though outcomes were less consistent for severe deformities. MIBS was more cost-effective over time, owing to shorter operating times and faster recovery. Rehabilitation was accelerated, and wound complications were fewer with MIBS. However, open techniques remained preferable for severe deformities due to their reliability in complex corrections. : MIBS offers substantial advantages for most patients undergoing bunion surgery, including faster recovery and fewer complications. However, open techniques may be better suited for severe deformities. Further research is needed to refine patient selection criteria and evaluate long-term outcomes in diverse populations.

摘要

拇外翻,即拇囊炎,是一种常见的足部畸形,会导致疼痛、活动受限以及生活质量下降。手术治疗方法包括微创技术和传统开放技术,但最佳治疗方法仍存在争议。本系统评价评估了这些方法的长期疗效、患者满意度、成本效益、患者个体因素的影响、康复方案以及并发症发生率。

对PubMed、Medline、EMBASE和Cochrane数据库进行全面检索,共识别出过去15年内发表的22项研究,每项研究的最短随访时间为2年。本系统评价遵循PRISMA-ScR指南。符合条件的研究报告了六项关键结局中的至少一项,并提取了影像学和临床结果、患者满意度、成本、康复时间以及不良事件等数据。

与开放手术相比,微创拇囊炎手术(MIBS)恢复更快、患者满意度更高且生活质量得到改善。包括拇外翻和跖间角矫正在内的影像学结局较为持久,不过对于严重畸形,结果的一致性较差。随着时间推移,MIBS更具成本效益,因为其手术时间更短且恢复更快。MIBS加速了康复进程,伤口并发症也更少。然而,由于开放技术在复杂矫正方面的可靠性,对于严重畸形而言,开放技术仍是更优选择。

对于大多数接受拇囊炎手术的患者,MIBS具有显著优势,包括恢复更快和并发症更少。然而,开放技术可能更适合严重畸形。需要进一步研究以完善患者选择标准,并评估不同人群的长期结局。

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