分离改良Lapidus手术能改变后足对中吗?回顾性影像学研究。

IF 1.3 4区 医学 Q2 Medicine
Ramy Samargandi, Aimery Sabelle, Jean Brilhault, Julien Berhouet, Rayane Benhenneda
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引用次数: 0

摘要

目的:考虑到内侧柱稳定对距骨定位的潜在影响,本研究旨在评估采用改良Lapidus手术进行第一跗跖关节(TMT-1)融合术对后足冠状位的影响。研究设计:进行回顾性影像学分析。方法:我们回顾了40例54英尺的患者(平均年龄60.6±9.78岁),他们接受了孤立的改良Lapidus手术,平均随访29.6±13.9个月。使用加压螺钉和足底钢板进行固定。术前和术后12个月的负重足底背、侧位和体表视图进行分析。影像学测量由两名资深外科医生独立完成,并评估了观察者间的可靠性。重要的是,仅评估了影像学结果。结果:采用m诈骗犯的圆角法,m诈骗犯的后足外翻明显减小(观察者1为-2.0±2.0°,观察者2为-2.44±1.84°,p均< 0.001)。Djian的后足外翻角也显著减小(观察者1为-1.44±0.98°,p < 0.001;观察者2为-1.67±4.09°,p = 0.004)。观察者间信度良好(ICC = 分别为0.87和0.80)。结论:改良Lapidus手术可显著减少后足外翻,表明其对内侧柱和后足有稳定作用。尽管需要进一步的临床验证,但这些影像学结果可以为拇外翻合并平足患者的手术计划提供参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can an Isolated Modified Lapidus Procedure Alter Hindfoot Alignment? A Retrospective Radiographic Study.

Purpose: The study aimed to evaluate the effect of first tarsometatarsal joint (TMT-1) arthrodesis using the modified Lapidus procedure on coronal hindfoot alignment, given the potential influence of medial column stabilization on talar positioning.

Study design: A retrospective radiographic analysis was performed.

Methods: We reviewed 54 feet in 40 patients (mean age 60.6 ± 9.78 years) who underwent an isolated modified Lapidus procedure with an average follow-up of 29.6 ± 13.9 months. Fixation was achieved using a compression screw and plantar plate. Preoperative and 12-month postoperative weight-bearing dorsoplantar, lateral, and Méary views were analyzed. Radiographic measurements were independently performed by two senior surgeons and assessed for inter-observer reliability. Importantly, only radiographic outcomes were evaluated.

Results: On Méary view, hindfoot valgus decreased significantly using the Méary's circle angle method (-2.0 ± 2.0° for observer 1 and -2.44 ± 1.84° for observer 2; p < 0.001 for both). Djian's hindfoot valgus angle also decreased significantly (-1.44 ± 0.98°, p < 0.001 for observer 1; -1.67 ± 4.09°, p = 0.004 for observer 2). Inter-observer reliability was good (ICC = 0.87 and 0.80, respectively).

Conclusion: The modified Lapidus procedure resulted in a significant radiographic reduction in hindfoot valgus, suggesting a stabilizing effect on the medial column and hindfoot. These radiographic findings may inform surgical planning in patients with hallux valgus and concomitant flatfoot, although further clinical validation is required.

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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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