Hallux valgus treatment by percutaneous scarf-like screwless osteotomy: surgical technique and medium-term outcomes.

IF 2.3 3区 医学 Q2 ORTHOPEDICS
Yair Green Halimi, Ben Efrima, Marc Elkaïm
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引用次数: 0

Abstract

Background: Hallux valgus is a common condition. There is a consensus that distal metatarsal osteotomies have positive outcomes for the correction of mild-to-moderate deformities, and that proximal osteotomies are preferable for more severe ones. The well-known scarf osteotomy technique is considered powerful enough for both types of deformation and is described without internal fixation. We aimed to describe a new surgical technique for hallux valgus percutaneous scarf like osteotomy (PSLO) without internal fixation, and to report the medium-term radiological and clinical outcomes.

Hypothesis: A combination of a PSLO without internal fixation will lead to optimal results.

Patients and methods: This retrospective case series reports on 126 cases involving 106 patients who underwent hallux valgus surgery with the PSLO technique +/- Akin, +/- lateral release. The osteotomy was stabilized by a bandage, and immediate weight bearing was allowed. The surgeries took place in 3 clinics in France from March 2016 to July 2017.

Results: All radiological parameters: hallux valgus angle (HVA), the 1-2 intermetatarsal angle (IMA) and the distal metatarsal articular angle (DMAA) showed statistically significant improvement. The mean preoperative HVA, IMA and DMAA were 27.7 °, 14.2 ° and 12.7 ° respectively. The mean postoperative HVA, IMA and DMAA were 8.23 °, 8.1 ° and 3.8 °, respectively. Clinically, 97% were satisfied or very satisfied with the results, 92% could wear "normal" shoes (45 days - 6 months), 99% returned to the same athletic activities after surgery (3-5 months), and the average time to return to work was 4 weeks (1 day - 51 days).

Discussion: The combination of scarf -like osteotomy and the percutaneous technique provide sufficient initial stabilization through the large horizontal area of contact between the fragments and the preservation of the attachment of the soft tissue. The lack of internal fixation significantly shortens the surgery time, cost, and reduces x-ray exposure without compromising the results.

Level of evidence: III, retrospective comparative study.

通过经皮瘢痕样无螺钉截骨术治疗拇指外翻:手术技术和中期疗效。
背景介绍拇指外翻是一种常见病。目前有一种共识,即跖骨远端截骨术对轻度至中度畸形的矫正有积极的效果,而对较严重的畸形则更倾向于近端截骨术。众所周知的疤痕截骨术被认为足以矫正这两种类型的畸形,而且无需内固定。我们旨在描述一种新的无内固定经皮瘢痕类截骨术(PSLO),并报告中期放射学和临床结果:假设:不使用内固定的经皮瘢痕类截骨术(PSLO)将会获得最佳效果:该回顾性病例系列报告了126个病例,涉及106名接受PSLO技术+/- Akin+/-侧方松解术的患者。截骨后用绷带固定,可立即负重。手术于2016年3月至2017年7月在法国的3家诊所进行:所有放射学参数:拇指外翻角度(HVA)、1-2跖骨间角度(IMA)和远端跖骨关节角度(DMAA)均有统计学意义的显著改善。术前 HVA、IMA 和 DMAA 的平均值分别为 27.7°、14.2° 和 12.7°。术后 HVA、IMA 和 DMAA 的平均值分别为 8.23°、8.1° 和 3.8°。临床上,97%的患者对手术效果表示满意或非常满意,92%的患者可以穿 "正常 "鞋(45天-6个月),99%的患者术后(3-5个月)恢复了同样的体育活动,恢复工作的平均时间为4周(1天-51天):讨论:巾状截骨术与经皮技术相结合,通过碎片之间的大面积水平接触和软组织附着的保留,提供了足够的初始稳定性。无需内固定,大大缩短了手术时间,降低了手术成本,减少了X光照射,同时不影响手术效果:证据等级:III,回顾性比较研究。
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
CiteScore
5.10
自引率
26.10%
发文量
329
审稿时长
12.5 weeks
期刊介绍: Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.
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