Neary M T, Jones R O, Sunshein K, Van Manen W, Youngberg R
Madigan Army Medical Center, Podiatry Department, Tacoma, Washington 98431.
J Foot Ankle Surg. 1993 Sep-Oct;32(5):530-5.
A prospective study is described of 12 consecutive patients with hallux abducto valgus deformity in whom an Austin osteotomy without lateral release was performed. All patients had similar postoperative care and magnetic resonance images (MRI) studies of their first metatarsals. The MRI was performed in T1- and T2-weighted images with algorithms programmed to image changes in the bone consistent with avascular necrosis of the first metatarsal head. One of the 12 patients following Austin osteotomy without lateral release had changes on MRI consistent with avascular necrosis of the first metatarsal head. These results were then compared with the prior study of 20 patients that had the Austin osteotomy with lateral release using the Fisher's exact test for small populations, and a value of 0.023 was found (0.05 > 95% confidence level). The Austin osteotomy with lateral release significantly increases the risk of developing avascular necrosis of the first metatarsal head and should only be performed in instances where the soft tissue contracture is largely contributing to the hallux abducto valgus deformity.
本文描述了一项前瞻性研究，对12例连续的拇外翻畸形患者进行了不伴外侧松解的奥斯汀截骨术。所有患者术后护理相似，并对其第一跖骨进行了磁共振成像（MRI）检查。MRI采用T1加权和T2加权图像，通过编程算法对与第一跖骨头缺血性坏死相符的骨变化进行成像。12例接受不伴外侧松解的奥斯汀截骨术的患者中，有1例MRI显示有与第一跖骨头缺血性坏死相符的变化。然后，使用针对小样本的Fisher精确检验，将这些结果与之前对20例接受伴外侧松解的奥斯汀截骨术患者的研究进行比较，发现P值为0.023（0.05＞95%置信水平）。伴外侧松解的奥斯汀截骨术显著增加了第一跖骨头发生缺血性坏死的风险，仅应在软组织挛缩在很大程度上导致拇外翻畸形的情况下进行。
