Retrospective Analysis of Radiographic Outcomes After Closing Base Wedge Osteotomy for Correction of Bunion Deformity.

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Clark K Brackney, Hayden L Hoffler, Rebecca R Sikora, Stephen J Tilles
{"title":"Retrospective Analysis of Radiographic Outcomes After Closing Base Wedge Osteotomy for Correction of Bunion Deformity.","authors":"Clark K Brackney, Hayden L Hoffler, Rebecca R Sikora, Stephen J Tilles","doi":"10.7547/21-079","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Closing base wedge osteotomy (CBWO) is a common procedure to correct severe bunion deformities with high intermetatarsal angles. There are few data demonstrating the radiographic success of CBWOs.</p><p><strong>Methods: </strong>We evaluated the radiographic outcomes of a CBWO. The primary aim was to assess the change in elevatus after a CBWO. Secondary aims included measuring the change in hallux abductus (HA) and intermetatarsal angles after the osteotomy. The medical records of 24 consecutive patients across 4 years were reviewed. All of the CBWOs were fixated with either one screw and one Kirschner wire or two screws. We hypothesized that the CBWO would reduce the amount of elevatus present.</p><p><strong>Results: </strong>The mean patient age was 35 years. Average preoperative HA and intermetatarsal angles were 35.2° and 15.7°, respectively. Mean postoperative HA and intermetatarsal angles at last radiographic follow-up were 13.3° and 6.1°, respectively. The change in HA and intermetatarsal angles was 21.9° and 9.6°, respectively. All of the patients achieved clinical union. Mean radiographic follow-up was 6 months; median radiographic follow-up was 5 months. The mean preoperative elevatus measurement was 3.5 mm; the mean postoperative elevatus measurement was 2.0 mm (difference, -1.6 mm; P = .0282), indicating that the osteotomy plantarflexed the first metatarsal. Three patients had radiographic evidence of postoperative elevatus; they were asymptomatic at the last clinical follow-up.</p><p><strong>Conclusions: </strong>Although clinical concern persists for the development of postoperative elevatus with CBWO, this case series showed plantarflexion of the CBWO. The CBWO is a powerful yet stable procedure for severe bunion deformities and should be viewed as a viable alternative to the Lapidus procedure.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Podiatric Medical Association","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7547/21-079","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Closing base wedge osteotomy (CBWO) is a common procedure to correct severe bunion deformities with high intermetatarsal angles. There are few data demonstrating the radiographic success of CBWOs.

Methods: We evaluated the radiographic outcomes of a CBWO. The primary aim was to assess the change in elevatus after a CBWO. Secondary aims included measuring the change in hallux abductus (HA) and intermetatarsal angles after the osteotomy. The medical records of 24 consecutive patients across 4 years were reviewed. All of the CBWOs were fixated with either one screw and one Kirschner wire or two screws. We hypothesized that the CBWO would reduce the amount of elevatus present.

Results: The mean patient age was 35 years. Average preoperative HA and intermetatarsal angles were 35.2° and 15.7°, respectively. Mean postoperative HA and intermetatarsal angles at last radiographic follow-up were 13.3° and 6.1°, respectively. The change in HA and intermetatarsal angles was 21.9° and 9.6°, respectively. All of the patients achieved clinical union. Mean radiographic follow-up was 6 months; median radiographic follow-up was 5 months. The mean preoperative elevatus measurement was 3.5 mm; the mean postoperative elevatus measurement was 2.0 mm (difference, -1.6 mm; P = .0282), indicating that the osteotomy plantarflexed the first metatarsal. Three patients had radiographic evidence of postoperative elevatus; they were asymptomatic at the last clinical follow-up.

Conclusions: Although clinical concern persists for the development of postoperative elevatus with CBWO, this case series showed plantarflexion of the CBWO. The CBWO is a powerful yet stable procedure for severe bunion deformities and should be viewed as a viable alternative to the Lapidus procedure.

拇趾外翻畸形闭合基底楔形截骨术后放射学效果回顾性分析
背景:闭合基底楔形截骨术(CBWO)是矫正跖骨间夹角过高的严重拇趾外翻畸形的常见手术。很少有数据显示 CBWO 在放射学方面取得了成功:我们对 CBWO 的放射学结果进行了评估。方法:我们评估了 CBWO 的放射学结果,主要目的是评估 CBWO 后趾骨隆起的变化。次要目的包括测量截骨后拇指外展(HA)和跖骨间角度的变化。研究人员回顾了 24 名连续患者 4 年的医疗记录。所有 CBWO 均使用一颗螺钉和一根 Kirschner 钢丝或两颗螺钉固定。我们假设 CBWO 可以减少存在的隆起量:患者平均年龄为 35 岁。术前HA和跖骨间的平均角度分别为35.2°和15.7°。术后最后一次X光随访时,HA和跖骨间夹角的平均值分别为13.3°和6.1°。HA和跖骨间角度的变化分别为21.9°和9.6°。所有患者都达到了临床愈合。平均影像学随访时间为6个月,中位随访时间为5个月。术前的平均抬高测量值为3.5毫米;术后的平均抬高测量值为2.0毫米(差异为-1.6毫米;P = 0.0282),表明截骨术使第一跖骨跖屈。三位患者术后有抬高的影像学证据;他们在最后一次临床随访时均无症状:尽管临床上仍然担心 CBWO 会导致术后隆起,但本系列病例显示 CBWO 可以跖屈。对于严重的拇趾外翻畸形,CBWO 是一种强大而稳定的手术,应被视为 Lapidus 手术的可行替代方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信