经皮截骨矫正母外翻畸形

Percutaneous osteotomy for correction of hallux valgus deformity

摘要:

[目的]本研究旨在评估经皮截骨矫正母外翻畸形的临床结果。[方法]回顾性分析 2020 年—2023 年接受经皮截骨矫正母外翻手术的 20 例患者资料。所有患者均接受经皮 Chevron 截骨，必要时增加经皮 Akin 截骨。评估临床与影像资料。 [结果]所有患者均顺利手术，无血管、神经损伤等严重并发症。所有患者均获随访 12 个月以上，随时间推移，患者疼痛视觉模拟评分 （visual analogue scale, VAS） [(6.0±0.9), (3.2±0.8), (0.7±0.5), P＜0.001] 和曼彻斯特-牛津足部问卷 （Manchester-Oxford Foot Questionnaire, MOXFQ）评分 [(66.5±3.1), (53.2±3.9), (12.9±3.0), P＜0.001] 均显著减少；而美国骨科足踝协会（American Orthopaedic Foot & Ankle Society, AOFAS） 评分显著增加 [(49.4±5.4), (65.2±5.8), (88.9±3.2), P＜0.001]。至末次随访时，20 例患者均无畸形复发，无翻修手术。影像方面，与术前相比，术后 3 个月和末次随访时患者母外翻角（hallux valgus angle, HVA) [(37.0±8.1)°, (19.7± 3.1)°, (19.8±3.3)°, P＜0.001] 和第 1 跖骨间角（intermetatarsal angle, IMA）[(16.9±3.0)°, (9.5±1.3)°, (9.6±1.7)°, P＜0.001] 均显著减少。 术后 6 个月时，所有患者截骨均愈合。[结论]经皮截骨矫正母外翻手术创伤小，患者恢复快，是一种安全有效的治疗方法。

Abstract:

[Objective] To evaluate the clinical outcome of percutaneous osteotomy for correction of hallux valgus deformity. [Methods] A retrospective study was conducted on 20 patients who received percutaneous osteotomy to correct hallux valgus deformity from 2020 to 2023. All patients received percutaneous Chevron osteotomy, while percutaneous Akin osteotomy added if necessary. The clinical and imaging data were evaluated. [Results] All patients were successfully operated without serious complications such as vascular and nerve injury, and followed up for more than 12 months. With time elapsed preoperatively, 3 months postoperatively and the latest follow-up, the pain visual analogue scale (VAS) [(6.0±0.9), (3.2±0.8), (0.7±0.5), P＜0.001] and the Mancher-Oxford Foot Questionnaire (MOXFQ) score [(66.5±3.1), (53.2±3.9), (12.9±3.0), P＜0.001] were significantly reduced, whereas the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores [(49.4±5.4), (65.2±5.8), (88.9±3.2), P＜0.001] was significantly increased. Up to the latest follow-up, none of the 20 patients had recurrent deformity or revision surgery. As for Imaging, compared to those preoperatively, the hallux valgus angle (HVA) [(37.0±8.1)°, (19.7± 3.1)°, (19.8±3.3)°, P＜0.001] and the 1st intermetatarsal angle (IMA) [(16.9±3.0)°, (9.5±1.3)°, (9.6±1.7)°, P＜0.001] were significantly declined 3 months after surgery and at the last follow-up. All patients had osteotomy healed 6 months after surgery. [Conclusion] Percutaneous osteotomy for correction of hallux valgus deformity is a safe and effective technique with advantages of minimal iatrogenic trauma and rapid recovery.