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Title: [Short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy for hallux valgus with moderate and severe metatarsus adductus].
Author: Chang X, Zhang Y, Yang J, Li Y, Zhang Y, Wen X, Liang X.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2020 Jan 15; 34(1):37-40. PubMed ID: 31939232.
Abstract:
OBJECTIVE: To evaluate the short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy in treatment of hallux valgus with moderate and severe metatarsus adductus. METHODS: Between February 2012 and September 2016, 10 patients (12 feet) of hallux valgus with moderate and severe metatarsus adductus were admitted and treated with the first ray tri-plane osteotomy and other metatarsal basal osteotomy and lateral soft tissue release. There were 1 male (2 feet) and 9 females (10 feet) with an average age of 34.5 years (range, 21-55 years). The disease duration ranged from 3 to 10 years (mean, 5.8 years). The degree of metatarsal adductus was moderate in 4 feet and severe in 8 feet according to modified Sgarlato measurement method. Preoperative American Orthopaedic Foot and Ankle Society (AOFAS) score was 46.4±9.3. The metatarsus adductus angle (MAA) was (25.41±3.66)°, hallux valgus angle (HVA) was (41.42±9.67)°, and the first-second intermetatarsal angle (1-2IMA) was (10.72±2.26)°. RESULTS: All incisions healed by first intention. All patients were followed up 18-24 months, with an average of 21.4 months. One patient (1 foot) had metastatic metatarsalgia after operation, but the symptoms disappeared after symptomatic treatment. X-ray re-examination showed that all osteotomies healed, and the healing time was 2.4-3.2 months, with an average of 2.8 months. At last follow-up, MAA was (8.42±0.71)°, HVA was (13.29±1.03)°, 1-2IMA was (4.41±0.48)°, and AOFAS score was 89.8±5.9. There were significant differences in clinical and radiographic indexes between pre- and post-operation ( P<0.05). CONCLUSION: The first ray tri-plane osteotomy combined with other metatarsal basal osteotomy has a significant short-term effectiveness in the treatment of hallux valgus with moderate and severe metatarsus adductus. 目的: 探讨第 1 跖列三平面截骨联合其余跖骨基底截骨治疗中重度跖内收型踇外翻的早期疗效。. 方法: 2012 年 2 月—2016 年 9 月，收治 10 例（12 足）中重度跖内收型踇外翻患者。男 1 例（2 足），女 9 例（10 足）；年龄 21～55 岁，平均 34.5 岁。病程 3～10 年，平均 5.8 年。根据改良 Sgarlato 测量法对跖内收分度：中度 4 足、重度 8 足。术前美国矫形足踝协会（AOFAS）评分为（46.4±9.3）分；跖内收角（metatarsus adductus angle，MAA）为（25.41±3.66）°，踇外翻角（hallux valgus angle，HVA）为（41.42±9.67）°，第 1-2 跖骨间角（first-second intermetatarsal angle，1-2IMA）为（10.72±2.26）°。采用第 1 跖列三平面截骨联合其余跖骨基底截骨以及外侧软组织松解术治疗。. 结果: 术后切口均 Ⅰ 期愈合。患者均获随访，随访时间 18～24 个月，平均 21.4 个月。1 例（1 足）术后出现转移性跖痛，对症处理后症状消失。X 线片复查示截骨部位均愈合，愈合时间为 2.4～3.2 个月，平均 2.8 个月。末次随访时，MAA 为（8.42±0.71）°、HVA 为（13.29±1.03）°、1-2IMA 为（4.41±0.48）°，AOFAS 评分为（89.8±5.9）分，均较术前明显改善（ P<0.05）。. 结论: 第 1 跖列三平面截骨联合其余跖骨基底截骨治疗中重度跖内收型踇外翻，可获得较好早期疗效。.

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