颈前路椎体次全切除减压融合术治疗多节段脊髓型颈椎病的疗效分析

目的:研究颈前路椎体次全切除减压融合术治疗多节段脊髓型颈椎病的效果.方法:选取我院2014年5月-2021年 7 月收治的多节段脊髓型颈椎病患者73例作为研究对象.随机将患者分为对照组(n=36)和观察组(n=37).对照组采用前路颈椎间盘切除减压融合术(ACDF),观察组采用颈前路椎体次全切除减压融合术治疗(ACCF).分析对比两组手术情况及住院时间、脊髓功能(JOA评分)、疼痛程度(VAS量表)、颈椎生理曲度和 Cobb 角.结果:观察组手术时间少于对照组,术中出血量以及住院时间均大于对照组(P＜0.05),两组均未发生严重并发症.两组手术后JOA评分均有提高,VAS评分均有下降,且观察组JOA及VAS评分均优于对照组(P＜0.05).两组手术后颈椎生理曲度及颈椎Cobb角均有增大,且观察组颈椎生理曲度及颈椎Cobb角均大于对照组(P＜0.05).结论:ACCF相比于ACDF更能有效减轻多节段脊髓型颈椎病患者的临床症状,改善颈椎生理曲度,增强颈椎功能,值得临床推广应用.     

颈椎前路多节段融合术后邻椎病的再手术策略

目的 探讨颈椎前路多节段融合术后邻椎病的手术治疗策略。方法 对2015年至2020年我院收治的13例颈椎前路多节段融合术后邻椎病再手术治疗的患者进行回顾分析，采取颈椎前路Zero-P钢板固定术治疗8例单节段邻椎病，后路颈椎单开门椎管扩大成形术治疗5例2个节段邻椎病，采用JOA评分、VAS评分及NDI指数进行疗效评价，分析X线、CT或MRI影像学表现。结果 本组所有病例得到随访，平均随访11.6个月（6～24个月）。两种术式术后患者JOA评分、VAS评分、NDI指数均得到显著改善。颈椎前路Zero-P钢板术后内固定物位置良好，随访未见钢板螺钉松动，骨融合平均时间为7.6个月。颈椎后路单开门椎管扩大成形术治疗患者均未出现C5神经根麻痹、椎板再关门等并发症。结论颈椎前路多节段融合术后邻椎病再手术方式的选择应遵循个体化原则，单节段邻椎病且不伴严重后纵韧带骨化，可选择前路减压融合Zero-P固定术；邻椎病变节段≥2处，可选择后路单开门椎管扩大成形术。     

颈后路全内镜下颈椎间盘切除术与颈前路颈椎间盘切除植骨融合术治疗颈椎间盘突出症的疗效对比

目的比较颈后路全内镜下椎间盘切除术(PPECD)与颈前路颈椎间盘切除植骨融合术(ACDF)治疗单节段旁中央型颈椎间盘突出症的疗效和对邻近节段退变的影响。方法回顾性分析2016年1月至2018年1月期间在本院行手术治疗的88例单节段旁中央型颈椎间盘突出症患者病例资料。按照所行的手术方式分为PPECD组(n=42)及ACDF组(n=46)。比较两组患者的基线情况,手术前、后颈及上肢视觉疼痛评分(VAS),颈椎功能障碍指数(NDI),手术邻近节段左、右侧屈曲及前屈后伸测定值和颈椎相邻节段退变情况。结果两组患者术后随访时间均为12个月。末次随访时,两组患者颈及上肢VAS和NDI评分与术前相比均有改善(0.05),而两组间比较差异无统计学意义(0.05); PPECD组邻近节段左、右侧屈曲及前屈后伸测定值术前比差异无统计学意义(0.05),ACDF组较术前增大(0.05),并且大于PPECD组(0.05); PECD组颈椎邻近节段退变情况优于ACDF组(0.05)。结论 PPECD和ACDF均能显著改善单节段旁中央型颈椎间盘突出症患者的临床症状,但PPECD对维持患者术后颈椎活动度、减少术后邻近椎体节段退变有一定优势。     

颈椎前路Hybrid微创手术在多节段颈椎病治疗中的疗效观察

目的探讨颈椎前路Hybrid微创手术在多节段颈椎病治疗中的临床效果。方法选择2010年1月至2016年12月在内蒙古医科大学附属医院和北京大学第三医院治疗的多节段颈椎病患者46例,根据手术方案分为对照组(23例)和观察组(23例)。对照组采用传统前路长节段椎体次全切除减压术治疗,观察组采用颈椎前路Hybrid微创手术治疗,采用颈椎功能障碍指数(NDI)及日本骨科协会评估治疗分数(JOA)对治疗效果进行评估;采用直观模拟量表(VAS)对2组围术期疼痛进行评估,比较2组临床疗效及对疼痛的影响。结果观察组手术后NDI评分低于对照组,差异具有统计学意义(P 0. 05);观察组手术后JOA评分高于对照组,差异具有统计学意义(P 0. 05);观察组术后1 d、3 d及5 d VAS疼痛评分均低于对照组,差异具有统计学意义(P 0. 05);观察组术后并发症发生率为8. 70%,低于对照组的13. 04%,差异具有统计学意义(P 0. 05)。结论颈椎前路Hybrid微创手术用于多节段颈椎病效果理想,有助于改善患者颈椎功能,缓解患者疼痛。     

两种颈椎前路减压重建术治疗两节段颈椎病的疗效比较

目的比较两种颈椎前路减压重建术治疗两节段颈椎病的临床及影像学结果。方法 40例连续两个间隙病变的颈椎病患者,依据手术方式分为A、B两组。A组(n=22):颈前路椎体次全切除减压+钛网植骨、钢板内固定;B组(n=18):椎间盘切除减压、Solis椎体间植骨融合组。视觉模拟评分法(VAS)和日本整形外科学会(JOA)计分评价临床效果。用颈椎X线侧位片测量颈椎曲度、手术节段椎间高度评价影像学结果。结果平均随访26个月(14～37个月)。A、B两组随访末期VAS、JOA评分分别较术前有显著改善(P0.05),两组间比较无显著性差异(P0.05);A组随访末期融合节段椎间高度丢失较B组明显(P005)、B组颈椎曲度维持优于A组(P0.05);A组出血量和手术时间均大于B组(P0.05)。结论两种减压重建术均可获得良好的神经功能改善;就颈椎曲度、椎间高度、手术时间和出血量而言,B组术式有更多优势。     

纳米羟基磷灰石/聚酰胺66椎间融合器形状对颈椎前路融合效果的影响

背景：目前研究报道椎间融合器材料是影响颈椎病患者术后疗效的因素之一,但关于相同材料不同几何形状对颈椎病患者术后疗效的报道较少。目的：观察纳米羟基磷灰石/聚酰胺66椎间融合器形状对颈椎前路椎间盘切除融合疗效的影响。方法：回顾性分析2016年1月至2020年6月于西南医科大学附属医院行单节段颈椎前路椎间盘切除融合手术患者的临床资料,共122例,根据术中使用纳米羟基磷灰石/聚酰胺66椎间融合器形状不同分为柱形组(n=60)、马蹄形组(n=62)。对比两组患者手术前后的目测类比评分、颈椎功能障碍指数、融合节段高度、C_2-7角、融合节段矢状成角及椎间融合情况。结果与结论：(1)与术前比较,两组术后2 d、1年及末次随访的目测类比评分降低(P <0.05),术后6个月及末次随访的颈椎功能障碍指数影响降低(P <0.05);两组间手术前后的目测类比评分、颈椎功能障碍指数比较差异均无显著性意义(P> 0.05);(2)马蹄形组术后6,12个月的融合率高于柱形组(P <0.05),术后6,12个月的改良Brantigan评分均低于柱形组(P <0.05...     

颈椎动态稳定器在颈椎病治疗中的应用

目的：探讨应用颈椎动态稳定器(dynamic cervical implant,DCI)治疗颈椎病的安全性及早期临床疗效。方法2011年9月～2012年5月施行颈前路减压DCI植入术的患者11例,统计手术时间和术中出血量;观察有无手术并发症的发生;采用疼痛视觉模拟评分法（visual analogue score,VAS）和颈椎功能障碍指数(neck disability index,NDI)评分量表评估患者术前和术后的症状,按日本骨科协会(Japanese orthopaedic association,JOA)评分行术前、术后神经功能评估。结果11例患者均得到随访,其中手术时间(63.9±20.1) min;术中出血量(58.4±22.1) ml;无切口感染,植入物松动、移位、断裂,手术节段异位骨化及颈椎后凸畸形等并发症发生;术后3个月的疼痛VAS和NDI评分与术前比较明显减小,差异有统计学意义(P＜0.05);末次随访的JOA评分与术前及术后3个月比较有明显升高,差异有统计学意义(P＜0.05)。结论颈前路减压DCI植入术治疗颈椎病在减轻疼痛、恢复神经功能方面是安全有效的,且近期临床疗效满意。     

可变角度零切迹前路椎间融合内固定系统治疗脊髓型颈椎病：30个月随访

背景:目前颈椎前路椎间盘切除融合是手术治疗颈椎病的"金标准",其中颈前路零切迹椎间融合器逐渐在临床中推广并应用,具有良好的临床疗效及影像学结果。目的:评价可变角度零切迹前路椎间融合内固定系统在颈椎前路手术中治疗脊髓型颈椎病的中期疗效。方法:纳入2015年1月至2018年1月广州中医药大学第一附属医院收治的脊髓型颈椎病患者81例,其中42例采用可变角度零切迹前路椎间融合内固定系统行颈椎前路椎间盘切除减压融合治疗(试验组),39例采用传统钛板-cage系统行颈椎前路椎间盘切除减压融合治疗(对照组)。随访比较两组患者的目测类比评分、日本骨科协会(JOA)评分、颈椎Cobb-C角、颈椎Cobb-S角、椎间融合情况及并发症发生情况。试验方案已获得广州中医药大学第一附属医院伦理委员会批准(批件号:NO.JY2020199)。结果与结论:(1)两组患者术后的目测类比评分、JOA评分均较术前明显改善(P <0.05),两组间术后的目测类比评分与JOA评分比较差异均无显著性意义(P> 0.05);(2)两组术后3 d、30个月时的Cobb-S角较术前均有明显改善(P <0.05),试验...     

开胸手术与电视胸腔镜手术治疗自发性气胸的对比研究

目的 比较电视胸腔镜手术与开胸手术治疗自发性气胸的疗效.方法 将我院2009年-2010年收治的46例自发性气胸患者分为两组,分别采用常规开胸手术和电视胸腔镜手术进行治疗.比较两种术式的治疗效果和呼吸道并发症情况.结果 电视胸腔镜手术比常规开胸手术的术中出血量少(t=19.03,P<0.001),手术时间短(t=3.88,P<0.001),术后住院时间短(t=4.19,P<0.001),术后24 h VAS评分低(t=6.75,P<0.001),术后胸管留置时间少(t=4.42,P<0.001),呼吸道并发症低( χ2=5.45,P=0.02).结论 VATS治疗复发性自发性气胸复发率与开胸手术相近,但住院时间短、美观、微创,近、远期疗效均较好.     

四种前路手术治疗颈椎病疗效比较

目的:比较四种颈椎前路融合术治疗颈椎病的临床疗效.方法:241例颈椎病患者分为A、B、C、D四组.A组采用前路减压单纯髂骨植骨术治疗,其中单节段40例,双节段22例;B组采用前路减压界面固定术(CIFC)治疗,其中单节段40例,双节段21例;C组采用植骨融合并颈椎前路钢板内固定术治疗,其中单节段45例,双节段23例;D组采用CIFC并前路钢板内固定术治疗,其中单节段35例,双节段15例.术后定期随访及拍摄X线片,观察疗效、椎间高度、颈椎前弯曲度和融合情况.结果:平均随访时间3.2a.植骨融合率A组为82.1%,B组为96.3%,C组为95.6%,D组为95.4%.终访时,A组平均椎间高度和颈椎前弯曲度较术后2周之间有差异(P＜0.05),B组、C组和D组之间无明显差(P＞0.05).A组与B、C组和D组远期疗效之间差异均有统计学意义(P＜0.05),B组与C组和D组远期疗效之间无明显差异(P＞0.05).结论:单纯髂骨植骨方法简单,但并发症较多.CIFC、颈椎前路钢板植骨融合内固定和CIFC并前路钢板内固定,固定牢固,符合颈椎生物力学特性,并发症少,远期疗效好.     

Impact of motor vehicle accidents on neck pain and disability in general practice

BACKGROUND: High levels of continuous neck pain after a motor vehicle accident (MVA) are reported in cross-sectional studies. Knowledge of this association in general practice is limited. AIM: To compare the differences in perceived pain and disability in patients with acute neck pain due to an MVA versus other self-reported causes. The secondary aim was to identify prognostic factors for continuous neck pain. DESIGN OF STUDY: Prospective cohort study with 1-year follow-up. SETTING: General practices in Rotterdam and its suburban region. METHOD: Patients with non-specific acute neck pain were invited to participate. Questionnaires were collected at baseline and after 6, 12, 26, and 52 weeks. The numerical pain-rating scale (NRS) and the neck disability index (NDI) were measured. Regression analysis was used to identify prognostic factors for continuous neck pain. RESULTS: A total of 187 patients were included. The MVA subgroup (n = 42) was significantly younger (P = 0.007), reported more sick leave (P = 0.037), higher levels of headache (P<0.001) and higher NDI scores at baseline (P = 0.018) but lower scores for previous neck pain (P = 0.015) compared to the remaining cohort. At follow-up the MVA subgroup had higher scores for continuous neck pain (63% versus 40%) and at the NDI (11.0 versus 7.1). After multivariate analysis 'pain in the upper part of the neck' (odds ratio [OR] = 1.6), 'duration of complaints at baseline longer than 2 weeks' (OR = 5.3), and an 'MVA' (OR = 5.3) were significantly correlated with outcome. CONCLUSION: Individuals exposed to MVAs constitute a relevant subgroup of patients with neck pain. An MVA and a longer duration of complaints are prognostic factors for continuous neck pain.     

后路全脊柱内镜下Key-hole侧块减压髓核摘除术治疗单节段神经根型颈椎病的临床应用

目的 探讨后路全脊柱内镜下微创Key-hole侧块减压髓核摘除术(ACDF)治疗单节段神经根型颈椎病患者的临床效果。方法 回顾性分析2016年3月-2018年12月徐州市中心医院40例单节段神经根型颈椎病患者的临床资料,其中男23例、女17例,年龄32~76岁。根据手术方式不同分组,行颈椎前路椎间盘切除椎间融合术(ACDF)20例为开放组,行后路全脊柱内镜下微创Key-hole侧块减压髓核摘除术20例为内镜组。比较两组患者的基线资料,以及手术时间、出血量、切口长度、住院时间、住院费用、术后并发症等;定期随访,比较两组患者术前和术后1、3、6、12个月及末次随访时,颈部及上肢疼痛视觉模拟评分(VAS)、颈椎功能障碍指数(NDI),末次随访采用Odom标准评定临床疗效。结果 两组患者基线资料差异均无统计学意义(P值均>0.01)。与开放组比较,内镜组手术时间短、出血少、切口小、住院时间短、费用低,差异均有统计学意义(t=3.451、15.844、49.438、6.772、28.311, P值均＜0.01)。术后随访12～24个月,开放组术后发生并发症1例,内镜组2例。开放组和内镜组术后1个月VAS分别为(2.90±0.42)、(2.11±0.29)分,NDI评分分别为(21.75±3.85)、(17.60±2.04)分,差异均有统计学意义(t=6.966、4.260, P值均<0.01);术前和术后3、6、12个月及末次随访时VAS、NDI评分组间比较,差异均无统计学意义(P值均>0.05)。末次随访根据Odom标准评定临床疗效,内镜组优14例、良4例,开放组患者中优15例、良3例,两组优良率比较差异无统计学意义(Z=-0.311,P>0.05)。结论 后路全脊柱内镜微创Key-hole侧块减压髓核摘除术与传统ACDF开放手术均可获满意临床疗效,但后路全脊柱内镜Key-hole侧块减压髓核摘除术具有创伤小、恢复快、费用少、安全性高等优点,值得临床推广应用。     

Direct Internal Fixation for Unstable Atlas Fractures

PurposeTo investigate the radiologic and clinical outcomes of direct internal fixation for unstable atlas fractures.Materials and MethodsThis retrospective study included 12 patients with unstable atlas fractures surgically treated using C1 lateral mass screws, rods, and transverse connector constructs. Nine lateral mass fractures with transverse atlantal ligament (TAL) avulsion injury and three 4-part fractures with TAL injury (two avulsion injuries, one TAL substance tear) were treated. Radiologic outcomes included the anterior atlantodental interval (AADI) in flexion and extension cervical spine lateral radiographs at 6 months and 1 year after treatment. CT was also performed to visualize bony healing of the atlas at 6 months and 1 year. Visual Analog Scale (VAS) scores for neck pain, Neck Disability Index (NDI) values, and cervical range of motion (flexion, extension, and rotation) were recorded at 6 months after surgery.ResultsThe mean postoperative extension and flexion AADIs were 3.79±1.56 (mean±SD) and 3.13±1.01 mm, respectively. Then mean AADI was 3.42±1.34 and 3.33±1.24 mm at 6 months and 1 year after surgery, respectively. At 1 year after surgery, 11 patients showed bony healing of the atlas on CT images. Only one patient underwent revision surgery 8 months after primary surgery due to nonunion and instability findings. The mean VAS score for neck pain was 0.92±0.99, and the mean NDI value was 8.08±5.70.ConclusionC1 motion-preserving direct internal fixation technique results in good reduction and stabilization of unstable atlas fractures. This technique allows for the preservation of craniocervical and atlantoaxial motion.     

Revision Surgery for a Failed Artificial Disc

PurposeThis study aimed to present our experience with failures in C-TDR and revision surgery outcomes.Materials and MethodsWe retrospectively examined patients who underwent revision surgery due to the failure of C-TDR between May 2005 to March 2019. Thirteen patients (8 males and 5 females) were included in this study. The mean age was 46.1 years (range: 22–61 years), and the average follow-up period was 19.5 months (range: 12–64 months). The outcome measures of pre- and post-operative neck and arm pain using a visual analogue scale (VAS) and functional impairment were assessed using a modified Japanese Orthopedic Association (JOA) scale and the Neck Disability Index (NDI).ResultsThe main complaints of patients were posterior neck pain (77%), radiculopathy (62%), and/or myelopathy (62%). The causes of failure of C-TDR were improper indications for the procedure, osteolysis and mobile implant use, inappropriate techniques, and postoperative infection. The most common surgical level was C5–6, followed by C4–5. After revision surgery, the neck and arm pain VAS (preoperative vs. postoperative: 5.46 vs. 1.31; 4.86 vs. 1.08), a modified JOA scale (14.46 vs. 16.69), and the NDI (29.77 vs. 9.31) scores were much improved.ConclusionC-TDR is good surgical option. However, it is very important to adhere to strict surgical indications and contraindications to avoid failure of C-TDR. The results of reoperations were good regardless of the approach. Therefore, various reoperation options could be considered in patients with failed C-TDR.     

改良椎体成形术的临床探讨

目的 采用改良侧卧位单侧椎弓根入路椎体成形术治疗骨质疏松性骨折,探讨其治疗效果.方法 选取骨质疏松性脊柱骨折患者25例,均采用改良侧卧位单侧椎弓根入路实施椎体成形术,观察患者术前、术后VAS疼痛评分变化,记录患者术后并发症发生情况.结果 所有患者术后疼痛均明显缓解,VAS评分术前、术后1天、术后1周及术后3月分别为8.8±0.6、2.2±0.4、2.1±0.5及1.9±0.4.所用患者均获得随访,未发现与手术相关的并发症出现.结论 改良侧卧位单侧椎弓根入路椎体成形术治疗骨质疏松性骨折是安全有效的,值得临床推广.     

寰椎骨折前路复位内固定钢板置钉参数研究

目的　明确寰椎骨折前路复位内固定钢板寰椎侧块置钉可行性及置钉技术参数。 方法　用Mimics软件,对40例被检查者的CT数据进行三维重建,解剖测量,并模拟置入寰椎侧块螺钉,测量并获得置钉的技术参数。 结果　椎动脉孔内侧壁距离中线23.2 mm。寰椎后弓与寰椎侧块移行处内侧壁距离中线距离13.2 mm。寰椎侧块上位螺钉置钉点距离上关节面前缘6.2 mm,距离寰椎中线20.0 mm。上位螺钉长21.5 mm,于矢状面上成角范围向上1.5°～向下11.6°。寰椎侧块下位螺钉置钉点距离下关节面前缘8.9 mm,长15.2 mm,最大下倾角为20.7°,距离椎动脉孔内侧壁1.9 mm。距中线17.6~23.2 mm的侧块为JeRP钢板侧块螺钉置入的相对安全区域。 结论　寰椎侧块置入上下位螺钉具备可行性。置钉点及钉道方向必须根据患者术前的三维CT数据做最终的决定。上位螺钉置钉角度应宁下勿上,下位螺钉置钉角度应宁内勿外。     

医学结局研究用疼痛量表在腰痛患者中的信效度初步研究

目的:评价医学结局研究用疼痛量表(the Medical Outcomes Study Pain Measurement,MOSPM)的信度及效度。方法:58例临床慢性腰背痛患者评定MOSPM,以VAS和SF-36为效度标准进行自评,四周后重测MOSPM。对量表的内部一致性、重测信度和平行效度进行分析。结果:MOSPM标准化后的各条目分与总分的相关系数在0·72~0·94之间,其中疼痛平均程度项(条目6)与总分的相关系数为0·94(P<0·001),Cronbach sα系数为0·97。MOSPM各条目的重测相关系数为0·70~0·92,总分的相关系数为0·86(P<0·001)。MOSPM各条目分与VAS分的相关系数在0·49~0·89(P<0·001)之间,MOSPM总分与VAS分的相关系数为0·85(P<0·001)。SF-36除外生理机能分量表与5个MOSPM条目不相关、精神健康分量表与疼痛频率也不相关外,其余相关均有统计学意义,相关系数在-0·29~-0·92之间(P<0·05)。结论:MOSPM在慢性腰背痛患者中应用具有较好的信度和效度。     

在社区中应用分筋理筋手法治疗落枕的临床疗效分析

目的：探讨分筋理筋膜手法治疗落枕的临床效果,分析分筋理筋手法在社区的应用价值和优势,从而更好为社区居民服务,更好地发掘利用和推广分筋理筋技术。方法：选取2014年1月至2015年1月,新二和一社区健康服务中心诊治的120例落枕患者为研究对象,按照随机数表法将其分为观察组与对照组,其中对照组采用拔罐治疗,观察组采用分筋理筋手法治疗,评估两组患者的治疗效果以及治疗1次和3次后的VA S疼痛评分、VA S强直评分。结果：采用分筋理筋手法治疗的观察组其总有效率为98.3%,明显高于采用拔罐治疗的对照组88.3%,差异显著有统计学意义(P<0.05)。治疗1次后,观察组与对照组的VAS疼痛评分分别为(2.78±0.89)、(4.41±1.67)分,观察组的VAS疼痛评分显著低于对照组,二者比较有统计学差异(P<0.05);治疗3次后,观察组的VAS疼痛评分仍低于对照组(P<0.05)。治疗1次及治疗3次后,观察组的VAS强直评分均显著低于对照组,二者比较有统计学差异(P<0.05)。结论：采用分筋理筋手法治疗落枕具有较佳的疗效,方法简便,医疗风险较低,适宜在社区卫生中心推广应用。     

Coronal tibiofemoral subluxation is a risk factor for postoperative overcorrection in high tibial osteotomy

BackgroundSevere tibiofemoral (TF) subluxation > 10 mm is a contraindication for high tibial osteotomy (HTO). However, the relationship between the degree of preoperative TF subluxation at < 10 mm and postoperative radiographic/clinical outcomes remains unclear.MethodsSixty-seven patients who underwent open wedge HTO with a planned postoperative mechanical femorotibial angle (mFTA) of three degrees valgus were retrospectively studied. The minimal subluxation (MIN) group included 39 patients with TF subluxation < 5 mm, while the moderate subluxation (MOD) group included 28 patients with TF subluxation of five to 10 mm. The preoperative and one-year postoperative mFTA, TF subluxation, medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), preoperative Kellgren-Lawrence (K–L) grade and varus-valgus laxity were evaluated. Clinical scores and pain visual analogue scale (VAS) were also analyzed.ResultsThe mean preoperative TF values in the MIN and MOD groups were 3.1±1.0 mm and 6.7±1.6 mm (mean±standard deviation, p < 0.001), respectively, with no significant difference in K–L grades. The MIN group demonstrated a significantly smaller varus preoperative mFTA (p < 0.001), larger MPTA (p = 0.011), smaller JLCA (p = 0.004), and less varus laxity (p = 0.023). Postoperative TF subluxation, MPTAs, and JLCAs did not differ significantly between the two groups, while the postoperative mFTA was significantly different (p = 0.001), with unintended overcorrection in the MOD group. No significant difference in clinical scores and VAS were observed.ConclusionsAfter HTO, compared to patients with TF subluxation < 5 mm, patients with TF subluxation of five to 10 mm were more likely to demonstrate unintended valgus overcorrection on one-year postoperative radiography.