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Long-term efficacy analysis of minimal incision osteotomy for treatment of hallux valgus

2011-08-15孙卫东SunWeidongDeptOrthopWangjingHospChinAcadMedSciBeijing100102ChinOrthop2010301111331137

外科研究与新技术 2011年2期
关键词:卫东

孙卫东(Sun Weidong,Dept Orthop,Wangjing Hosp,Chin Acad Med Sci,Beijing 100102)…∥Chin J Orthop.-2010,30(11).-1133~1137

Long-term efficacy analysis of minimal incision osteotomy for treatment of hallux valgus

孙卫东(Sun Weidong,Dept Orthop,Wangjing Hosp,Chin Acad Med Sci,Beijing 100102)…∥Chin J Orthop.-2010,30(11).-1133~1137

ObjectiveTo evaluate the long-term results of minimal incision osteotomy for hallux valgus.MethodsFrom February 1996 to May 1999,372 cases(705 feet)with hallux valgus were treated with minimal incision osteotomy.Seventy-nine cases after surgery were followed up for more than 5 years,including 6 males(10 feet)and 73 females(140 feet)with an average age of 47 years(range,13 - 75 years).The average follow-up time was 7.5 years(range,5.3 - 13.2 years).The preoperative and postoperative hallux valgus angles(HVA),intermetatarsal angles(IMA),the tibial sesamoid position(TSP),American orthopedic foot and ankle society(AOFAS)score,range of movement of the first metatarsophalangeal joint,and lateral metatarsalgia etc.were observed and measured.And the clinic outcome were studied and evaluated.ResultsBased on Wen Jian-min’s clinic curative effectevaluation criterion(2001),56 feet(37.3%)were excellent,88 feet(58.7%)good,6 feet(4.0%)fair.The rate of excellent or good was 96.0%(144/150).The postoperative mean AOFAS score was 84.20 ±4.32 points(range,60 - 100 points).The mean HVA decreased from 33.28 to 12.31 degrees,the mean IMA from 11.75 to 6.80 degrees.The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 at final follow-up.There are no nonunion or delayed union of osteotomy,avascular necrosis of the 1st metatarsal head,infection,hallux varus.Four feet(2.7%)had numbness in the medial of the big toe.The 1st metatarsophalangeal joint range of motion decreased from 70.20 to 69.53 degrees.There were 97 feet(64.7%)with the 2 -5 metatarsalgia before operation,and 35 feet(23.3%)disappeared,54 feet(36.0%)improved,8 feet(5.3%)aggravated after operation.ConclusionMinimal incision osteotomy technique is a sound and reliable method to treat hallux valgus.The osteotomy technique is simple,and could provide satisfactory long-term results with lower complication rate.14 refs,3 figs,1 tab.

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