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拇僵硬的关节保留:评估改良 Chevron 截骨术联合广泛唇切除术的疗效

Joint preservation in hallux rigidus: evaluating the efficacy of modified chevron osteotomy with extensive cheilectomy.

作者信息

Masaragian Héctor José, Rega Leonel, Perin Fernando, de Allende Lucas, Fabrego César Miguel, Velasco Johann Luis Veizaga

机构信息

Buenos Aires, Argentina.

Buenos Aires, Argentina.

出版信息

J Foot Ankle Surg. 2025 Jul 24. doi: 10.1053/j.jfas.2025.07.006.

DOI:10.1053/j.jfas.2025.07.006
PMID:40714337
Abstract

BACKGROUND

Hallux rigidus is a degenerative condition of the first metatarsophalangeal joint, more frequently affecting females and individuals over 40 years. Various surgical options exist, but no prior studies have reported outcomes for distal shortening chevron osteotomy combined with extensive dorsal cheilectomy.

PURPOSE

To evaluate the clinical and functional outcomes of patients with hallux rigidus treated with distal shortening chevron osteotomy and extensive dorsal cheilectomy.

STUDY DESIGN

Retrospective case series.

METHODS

A total of 50 patients (51 feet) underwent surgery between 2015 and 2022. One patient had bilateral involvement. The mean age was 49.37 years; 46 % were male and 54 % female. Mean follow-up was 46.57 months (range, 6-81 months). Patients were assessed preoperatively and after surgery using the American Orthopaedic Foot & Ankle Society (AOFAS) score, range of motion (ROM), Visual Analogue Scale (VAS), and Foot and Ankle Ability Measure (FAAM).

RESULTS

Postoperative scores demonstrated statistically significant improvements across all measures. Patients reported decreased pain, improved joint mobility, and enhanced function. The majority expressed satisfaction and indicated a willingness to undergo the procedure again.

CONCLUSION

Distal shortening chevron osteotomy with extensive dorsal cheilectomy is a safe and effective surgical option for Coughlin grades I-III hallux rigidus. This technique yields consistent improvements in pain, mobility, and function, with high patient satisfaction.

摘要

背景

僵硬性拇趾炎是第一跖趾关节的一种退行性疾病,更常见于女性和40岁以上的人群。存在多种手术选择,但此前尚无研究报道远端缩短V形截骨术联合广泛背侧唇切除术的疗效。

目的

评估采用远端缩短V形截骨术和广泛背侧唇切除术治疗僵硬性拇趾炎患者的临床和功能疗效。

研究设计

回顾性病例系列研究。

方法

2015年至2022年间,共有50例患者(51足)接受了手术。1例患者为双侧受累。平均年龄为49.37岁;男性占46%,女性占54%。平均随访时间为46.57个月(范围6 - 81个月)。术前和术后使用美国矫形足踝协会(AOFAS)评分、活动范围(ROM)、视觉模拟量表(VAS)和足踝能力测量(FAAM)对患者进行评估。

结果

术后各项指标评分均有统计学意义的显著改善。患者报告疼痛减轻、关节活动度改善、功能增强。大多数患者表示满意,并表示愿意再次接受该手术。

结论

远端缩短V形截骨术联合广泛背侧唇切除术是治疗Coughlin I - III级僵硬性拇趾炎的一种安全有效的手术选择。该技术在疼痛、活动度和功能方面能持续改善,患者满意度高。

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Joint preservation in hallux rigidus: evaluating the efficacy of modified chevron osteotomy with extensive cheilectomy.拇僵硬的关节保留:评估改良 Chevron 截骨术联合广泛唇切除术的疗效
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