CAN THE PERCUTANEOUS CHEVRON AND AKIN (PECA) TECHNIQUE CORRECT THE PRONATION OF THE FIRST METATARSAL IN HALLUX VALGUS?

IF 0.5 4区医学 Q4 ORTHOPEDICS

Acta Ortopedica Brasileira Pub Date : 2023-06-09 eCollection Date: 2023-01-01 DOI:10.1590/1413-785220233102e265206

Gabriel Ferraz Ferreira, Mauro Cesar Mattos E Dinato, Tatiana Ferreira Dos Santos, Paulo Miziara, Miguel Viana Pereira

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Abstract

Objective: Pronation of the first metatarsal in hallux valgus has recently been discussed among foot and ankle surgeons. This study aimed to evaluate the potential radiographic correction of moderate and severe hallux valgus using the percutaneous Chevron and Akin (PECA) technique.

Methods: We evaluated 45 feet in 38 patients (mean age 65.3 years old [36 - 83]; 4 men; 34 women; 7 bilateral) who underwent surgical correction using the PECA technique. The radiographic images evaluated were anteroposterior radiographs obtained pre- and postoperatively at least 6 months after surgery, including the metatarsophalangeal angle, the intermetatarsal angle, pronation of the first metatarsal, displacement of the distal fragment, medial sesamoid position and bone union.

Results: All parameters evaluated showed significant postoperative improvement, including correction of pronation of the first metatarsal (p < .05) and position of the sesamoid (p < .05). There was a union of osteotomies in all feet. No complications were observed, such as screw loosening or necrosis of the first metatarsal head.

Conclusion: The PECA technique can correct pronation of the first metatarsal in moderate and severe hallux valgus, and other deformity-associated parameters. Level of Evidence IV; Case Series.

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经皮切弗隆和阿金（PECA）技术能否矫正外翻患者第一跖骨的前倾？

目的：近来，足踝外科医生一直在讨论外翻患者第一跖骨前凸的问题。本研究旨在评估使用经皮 Chevron 和 Akin（PECA）技术矫正中度和重度足外翻的影像学潜力：我们对使用 PECA 技术进行手术矫正的 38 名患者（平均年龄 65.3 岁 [36 - 83]；4 名男性；34 名女性；7 名双侧）的 45 只脚进行了评估。评估的X光图像为术前和术后至少6个月的前后位X光片，包括跖趾角度、跖骨间角度、第一跖骨的前倾、远端片段的移位、内侧趾骨位置和骨结合情况：所有评估参数在术后均有明显改善，包括第一跖骨前凸的矫正（p < .05）和芝麻状骨位置的矫正（p < .05）。所有足部的截骨都已愈合。未发现第一跖骨头螺钉松动或坏死等并发症：结论：PECA技术可以矫正中度和重度拇指外翻患者的第一跖骨前突以及其他畸形相关参数。证据等级 IV；病例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.