Ettinger Sarah, Spindler Fabian T, Marschall Ursula, Polzer Hans, Stukenborg-Colsman Christina, Baumbach Sebastian Felix
University Hospital for Orthopedics and Trauma Surgery, Pius Hospital, Oldenburg, Germany; Department of Orthopedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital Munich, Munich, Germany; BARMER Institute for Health System Research, Wuppertal, Germany; OrthoPlus Munich, Munich, Germany; Department of Foot and Ankle Surgery, Orthopedic Department of the Hannover Medical School at the DIAKOVERE Annastift, Hannover, Germany.
Dtsch Arztebl Int. 2025 May 30;122(11):308-314. doi: 10.3238/arztebl.m2025.0068.
Hallux valgus is a common deformity. Surgical treatment strategies have evolved markedly in recent years. We report on the administrative prevalence of this condition and the available treatments for it.
The administrative prevalence of hallux valgus and the treatments provided for it in Germany were determined from data supplied by BARMER, a statutory health insurance carrier. The classification and treatment of hallux valgus are outlined in a narrative overview, with particular attention to a meta-analysis.
The administrative prevalence of hallux valgus in Germany is nearly 2%; 83% of the affected persons are women. Over a 6-year period, the number of operations declined, and there was a trend toward outpatient treatment. Hallux valgus should be classified as either mild/moderate or severe. The common surgical procedures achieved comparable correction of the bony deformity. The AOFAS score improved by an average of 33.8 points (95% CI: [30.5; 37.0]) across all surgical techniques, reaching average postoperative values that ranged from 81.4±7.7 and 90.1±4.8 points depending on the particular technique used. The choice of technique and the duration of follow-up had no significant effect on the subjective treatment outcome. The overall complication rate after surgical correction was 18.5%. The common complications were metatarsalgia, recurrent deformity, stiffness of the first metatarsal joint, wound-healing disorders, and hallux varus.
The primary treatment of hallux valgus should be conservative. The various surgical techniques correct the bony deformity with comparable efficacy and good postoperative AOFAS scores. Patients with more severe deformities and greater impairment seem to have a higher potential for improvement in the AOFAS score.
拇外翻是一种常见的畸形。近年来，手术治疗策略有了显著发展。我们报告了这种疾病的管理患病率以及针对它的可用治疗方法。
根据法定健康保险公司BARMER提供的数据，确定了德国拇外翻的管理患病率及其治疗情况。以叙述性综述的形式概述了拇外翻的分类和治疗，特别关注一项荟萃分析。
德国拇外翻的管理患病率接近2%；83%的患者为女性。在6年期间，手术数量有所下降，并且有门诊治疗的趋势。拇外翻应分为轻度/中度或重度。常见的手术方法在矫正骨畸形方面取得了相当的效果。所有手术技术的美国足踝外科协会（AOFAS）评分平均提高了33.8分（95%置信区间：[30.5；37.0]），术后平均评分根据所使用的具体技术在81.4±7.7分至90.1±4.8分之间。技术选择和随访时间对主观治疗结果没有显著影响。手术矫正后的总体并发症发生率为18.5%。常见并发症包括跖痛症、复发性畸形、第一跖趾关节僵硬、伤口愈合障碍和拇内翻。
拇外翻的主要治疗应是保守治疗。各种手术技术在矫正骨畸形方面疗效相当，术后AOFAS评分良好。畸形更严重且功能受损更大的患者似乎在AOFAS评分上有更高的改善潜力。
