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101.
Ana Bia Francisco Guerra-Pinto Bruno S. Pereira Nuno Corte-Real Xavier Martin Oliva 《The Journal of foot and ankle surgery》2018,57(1):123-130
Percutaneous and minimally invasive surgery is one of the greatest advances in the operating field of orthopedic since the late 1990s. The potential advantages include a shorter operative time, quicker recovery, and reduced hospital stay compared with traditional open surgery. However, scientific validation of the safety and efficacy of hallux valgus (HV) percutaneous surgery remains inconclusive. The objective of the present study was to systematically review the published data and clinical evidence for percutaneous HV surgery, evaluate the scientific method of the reports, and clarify the indications, safety, efficacy, and potential risks of these surgical techniques. Two reviewers independently identified the studies using a PubMed search, with the keywords “hallux valgus,” “osteotomy,” “minimally invasive,” and “percutaneous.” Quality assessment was performed using the Coleman methodology scale, and each study was assigned a level of evidence and grade of recommendation. Eighteen studies were included and reported a total of 1534 procedures for percutaneous HV surgery on 1397 patients. Of the 18 studies, 14 (77.8%) were level IV, 2 (11.1%) were level III, and 2 (11.1%) were level II. Overall, the average angle correction of the HV deformity improved postoperatively. Regarding the complications, although some investigators revealed no major complications, others described deformity recurrence in 7.8%, stiffness of the first metatarsophalangeal joint in 9.8%, malunion in 4% to 8.7%, and infection rates ranging from 1.9% to 14.3%. The main indication for percutaneous HV surgery is the correction of mild deformities. The complication rate was elevated even in experienced surgeons. In conclusion, future research in percutaneous techniques should include adequately sized randomized control trials, standardization of treatment protocols, and the use of validated tools for the measurement of clinical outcomes. 相似文献
102.
103.
目的:应用X线平片进行二维测量,探讨[足母]外翻与足部其它畸形的相关性。方法:外翻手术患者共计24例27足,志愿者27例27足,常规进行足部正位、负重侧位摄片,测定[足母]外翻角、跖骨内收角、第1楔骨跖骨关节角、Ⅰ-Ⅱ跖骨间角、Ⅰ-Ⅴ跖骨间角、Ⅱ-Ⅴ跖骨间角、远端关节固定角、近端关节固定角、跟骨倾斜角、内弓顶角、距骨-第1跖骨角、跟骨关节面-胫骨轴线角,检测[足母]外翻与足部其它畸形的相关性。结果:正常足与[足母]外翻足的外翻角、跖骨内收角、第1楔跖关节角、Ⅰ-Ⅱ跖骨间角、Ⅰ-Ⅴ跖骨间角、远端关节固定角、内弓顶角、距骨~第1跖骨角之间存在显著差异;Ⅱ-Ⅴ跖骨间角、近端关节固定角与跟骨一胫骨轴线角之间未见明显差并。结论:[足母]外翻足存在第1跖骨内收畸形,原发于第1楔跖关节;与内侧纵弓塌陷导致的扁平足伴发,但是不一定会表现出扁平足症状。建议外翻术前进行必要的影像学检查,以单足负重正、侧位片为最佳,必要时增加跟骨轴位片.明确病变严重程度与伴发畸形,认真评价发病机制,合理选择治疗手段。 相似文献
104.
目的研究第1跖骨远端截骨后克氏针和绷带固定对拇外翻的作用效果。方法通过拇外翻的医学影像数据建立完整的三维足部有限元模型,此模型包括足骨、籽骨、软骨、韧带、软组织、跟腱等;分别建立克氏针和绷带固定的模型,分析拇外翻平衡站立时的足部受载特点。结果绷带固定下截骨之间的压应力(14.9 MPa)大于克氏针峰值应力(6.71 MPa)。从背侧、跖侧、内侧、外侧来看,克氏针固定对截骨面的稳定作用都优于绷带固定,更有利于截骨面的稳定。结论绷带固定可减少截骨端的愈合时间,有利于临床上拇外翻术后固定方式的优化选择。 相似文献
105.
Biomechanical investigation of two long bone growth modulation techniques by finite element simulations
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Manuel Schneider Jan Buschbaum Alexander Joeris Oliver Röhrle Jonathan Dwyer James B. Hunter Richard A.K. Reynolds Theodor F. Slongo Boyko Gueorguiev Peter Varga 《Journal of orthopaedic research》2018,36(5):1398-1405
106.
Ilker Abdullah Sarikaya Ali Seker Ozan Ali Erdal Mehmet Ali Talmac Muharrem Inan 《Acta orthopaedica et traumatologica turcica》2018,52(3):174-178
Objective
This study aimed to present a treatment algorithm for the correction of the hallux valgus deformity in Cerebral Palsy (CP) patients and to discuss the outcomes based on our clinical and radiological results.Methods
29 patients (45 feet) were included in the study. The mean age of the patients at the time of the surgery was 14 (range 6–22) years. The mean follow-up was 33 (range 22–59) months. A reconstructive procedure was performed on 19 patients (27 feet); a soft tissue surgery and exostectomy of the bunion in six patients (11 feet); and MTP joint arthrodesis in four patients (7 feet). The hallux valgus angle (HVA) and the anteroposterior intermetatarsal angle (IMA) were used for radiologic evaluation and the DuPont Bunion Rating Score was used for clinical evaluation.Results
The follow-up period was 36 (range 22–59) months in reconstructive group, 27 (range 24–29) months in soft tissue group, and 29 (range 23–41) months in MTP arthrodesis group. Significant improvements were detected in hallux valgus angle in three groups postoperatively but in soft tissue group correction loss was observed during follow up. Best results were achieved in arthrodesis group and worse in soft tissue group in terms of clinical evaluation.Conclusion
According to our results isolated soft tissue procedures are ineffective in CP patients. Soft tissue procedure combined with metatarsal osteotomy has satisfactory results.Level of evidence
Level IV, therapeutic study. 相似文献107.
Uğur Şaylı Elif Çiğdem Altunok Melih Güven Budak Akman Jnev Biros Ayşe Şaylı 《Acta orthopaedica et traumatologica turcica》2018,52(3):167-173
Objective
This survey was designed to evaluate the prevalence estimations of HV, bunionette, hammertoe as well as their relations to shoe wearing and also familial tendency, in Turkey.Material and Methods
Two thousand six hundred sixty two volunteers (1615 females and 1047 males) with a mean age of 34.15 ± 14.23 (range; 18 to 96) years were asked to answer the predetermined questionnaire between January and June, 2016. Hallux valgus, hammertoe and bunionette images were provided as references and every adult participant without any known forefoot problems or past forefoot surgery history was asked to rate his/her foot and to respond the questions about family history and shoe wearing habits. Responses were statistically analyzed.Results
The prevalence estimations of hallux valgus, bunionette and hammertoe were calculated as 54.3%, 13.8% and 8.9% and positive family history rates were 53.2%, 61.2% and 56.1%, respectively. All three deformities were more common in females than in males (p < 0.001). Nonetheless the older age group reported significantly higher prevalence rates for only HV (p < 0.001). Likewise, among the three deformities, females reported a higher rate of positive family history only in HV compared to men (p < 0.001). Constricting shoe wear was found to affect HV incidence in women (p < 0.001) and bunionette incidence in both sexes (p < 0.01).Conclusion
This study concludes that forefoot deformities are common with high familial tendency. Hence it is worthwhile to work on molecular genetics and this may enable the anticipation of forthcoming deformities in order to take early action in prevention, in nearly the half of the population. 相似文献108.
109.
Kenichiro Nakajima 《The Journal of foot and ankle surgery》2018,57(2):357-363
Arthroscopic treatments for the first metatarsophalangeal joint have not spread fully owing to a number of factors. First, in the common arthroscopic view, the joint is observed from above, which makes the structures difficult to grasp and the dorsal aspect of the joint difficult to visualize and treat. Second, techniques for widening the view have not yet been reported. Third, the portals necessary for observation and treatment with hallux sesamoids have not yet been established. Finally, techniques for detecting the sesamoids have not been previously reported. We have developed a method for first metatarsophalangeal joint arthroscopy by treating 14 patients with hallux rigidus and 9 patients with hallux sesamoid disorders. We report a new method that combines a variety of arthroscopic techniques. Our study has 4 novel points. First, in our arthroscopic technique, the joint can be examined from the medial side because traction is directly and horizontally applied to the great toe using an adjustable traction device with the surgeon standing on the unoperated side. The technique enables observation of the dorsal aspect of the metatarsal head and proximal phalanx and makes the structures easier to grasp. Second, the coagulator technique as an arthroscopic aid is demonstrated. Third, all aspects of the joint, including the sesamoids, can be observed through our 4 portals. Finally, techniques for detecting the sesamoids are identified. We believe our novel method will ensure that arthroscopy of the first metatarsophalangeal joint is easier than previously described methods. 相似文献
110.
Mun Chun Lai Jerry Yongqiang Chen Yeong Huei Ng Hwei Chi Chong Kevin Oon Thien Koo Inderjeet Singh Rikhraj 《Foot and Ankle Surgery》2018,24(4):291-295