与股骨后倾患者相比，股骨后倾和髋关节后撞击增加的成年患者股骨去旋截骨后足趾减少

IF 1.4 4区医学 Q3 ORTHOPEDICS

Journal of Hip Preservation Surgery Pub Date : 2022-01-01 DOI:10.1093/jhps/hnac001

T. Lerch, A. Boschung, C. Leibold, R. Kalla, H. Kerkeni, H. Baur, P. Eichelberger, K. Siebenrock, M. Tannast, S. Steppacher, Emanuel F. Liechti

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引用次数: 2

摘要

摘要足趾内侧与股骨高位内翻（FV）相关，而足趾外侧与股骨后倾相关。因此，我们报告了（i）足部进展角（FPA），（ii）内趾和外趾的患病率，以及（iii）接受股骨旋转截骨（FDO）治疗的患者的临床结果。我们对20名接受单侧FDO治疗的患者（20髋）进行了回顾性分析（2017-18）。其中14例患者FV升高，6例患者发生股骨后倾。随访时间平均为1 ± 1. 年。所有患者都进行了最少的1年随访，平均年龄为29岁 ± 8. 年。FV增加的患者（FV > 35°）后撞击试验呈阳性，平均FV为49 ± 11°（Murphy法）。6名股骨后倾角（FV）患者 < 10°）的前撞击试验呈阳性，平均FV为5 ± 4°。术前和随访时使用Gaitrite系统进行仪器步态分析，以测量FPA，并与18名健康无症状志愿者（36英尺，平均年龄29岁）的对照组进行比较 ± 6. 年）。（i）平均FPA显著增加（P = 0.006）从术前1.3 ± 7°至4.5 ± 随访时FV增加的患者为6°，与对照组相比没有显著差异（4.0 ± 4.5°）。（ii）对于FV增加的患者，从术前（5名患者）到随访（2名患者），趾内活动减少。从术前（两名患者）到随访（无患者），股骨后倾患者的趾外活动减少。（iii）所有患者的主观髋关节价值均显著增加（P < 0.001）。WOMAC当时12岁 ± 随访得8分。接受FDO的FV增加的患者走路时足趾较少。FDO有可能减少内向和外向，并提高随访时的主观满意度。

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Less in-toeing after femoral derotation osteotomy in adult patients with increased femoral version and posterior hip impingement compared to patients with femoral retroversion

ABSTRACT In-toeing of the foot was associated with high femoral version (FV), while Out-toeing was associated with femoral-retroversion. Therefore, we report on (i) foot-progression-angle (FPA), (ii) prevalence of In-toeing and Out-toeing, and (iii) clinical outcome of patients treated with femoral-derotation-osteotomy (FDO). We performed a retrospective analysis involving 20 patients (20 hips) treated with unilateral FDO (2017–18). Of them, 14 patients had increased FV, 6 patients had femoral-retroversion. Follow-up time was mean 1 ± 1 years. All patients had minimal 1-year follow-up and the mean age was 29 ± 8 years. Patients with increased FV (FV > 35°) presented with positive posterior-impingement-test and mean FV was 49 ± 11° (Murphy method). Six patients with femoral-retroversion (FV < 10°) had positive anterior impingement test and mean FV of 5 ± 4°. Instrumented gait analysis was performed preoperatively and at follow-up using the Gaitrite system to measure FPA and was compared to a control group of 18 healthy asymptomatic volunteers (36 feet, mean age 29 ± 6 years). (i) Mean FPA increased significantly (P = 0.006) from preoperative 1.3 ± 7° to 4.5 ± 6° at follow-up for patients with increased FV and was not significantly different compared to the control group (4.0 ± 4.5°). (ii) In-toeing decreased from preoperatively (five patients) to follow-up (two patients) for patients with increased FV. Out-toeing decreased from preoperatively (two patients) to follow-up (no patient) for patients with femoral-retroversion. (iii) Subjective-hip-value of all patients increased significantly (P < 0.001) from preoperative 21 to 78 points at follow-up. WOMAC was 12 ± 8 points at follow-up. Patients with increased FV that underwent FDO walked with less In-toeing. FDO has the potential to reduce In-toeing and Out-toeing and to improve subjective satisfaction at follow-up.

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来源期刊

Journal of Hip Preservation Surgery ORTHOPEDICS-

自引率

20.00%

发文量

审稿时长

12 weeks