采用改良Chevron截骨联合外侧软组织松解治疗重度拇外翻的疗效观察

目的 观察采用改良Chevron截骨联合外侧软组织松解治疗重度拇外翻的临床疗效.方法 回顾分析2018年3月至2019年4月北京积水潭医院院足踝外科应用改良Chevron截骨联合外侧软组织松解的以拇外翻角(HVA)增大为主的重度拇外翻患者22例(27足),对照组患者42例(50足).影像学检查包括HVA、第1、2跖骨轴...

Preliminary radiographic and clinical results of severe hallux valgus treated by lateral soft tissue release with modified Chevron osteotomy

Objective To assess radiographic and clinical outcomes of severe hallux valgus treated by lateral distal soft tissue release with modified Chevron osteotomy.Methods From March 2018 to April 2019,a retrospective analysis was performed to compare the utility of lateral soft tissue release with modified Chevron osteotomy for the treatment of 22 patients(27 feet)with severe hallux valgus mainly with enlarged hallux valgus angle(HVA)and 42 patients(50 feet)in the control group in Department of Foot and Ankle Surgery,Beijing Jishuitan Hospital.The radiologic outcomes were evaluated based on preoperative images and last follow-up images,including HVA,IMA,DMAA,and sesamoid position.The clinical results investigated based on the before operation and the last follow-up scores of AOFAS,FFI,VAS,patient satisfaction and postoperative complications.Results There was no statistical difference in general age,gender and follow-up time between the two groups of patients(P>0.05).There was no statistical difference in the preoperative AOFAS and IMA between the two groups.The preoperative VAS scores,HVA,DMAA,and HVA of the two groups were not statistically different.The preoperative sesamoid position(P=0.000)was statistically different.Compared with the control group,the severe group had a lower VAS score,but the HVA,DMAA and preoperative sesamoid position scores were higher.The two groups of patients were followed up for(15.63±1.49)months.The preoperative and postoperative comparisons of AOFAS,FFI,IMA,HVA,DMAA and sesamoid position of the two groups in the last follow-up were statistically significant(P=0.00).There was no significant difference in clinical and radiologic results between the two groups of patients after operation.In satisfaction analysis,87.7%of the control group reported good to excellent results,as did 95.9%of the severe group(P=0.64).There was no statistical difference in postoperative complications between the two groups.Conclusions The short-term radiologic and clinical results of patients with severe hallux valgus with increased HVA(HVA greater than 40°,IMA less than 17°)treated by lateral soft tissue release with modified Chevron osteotomy were favorable.The lateral soft tissue release with modified Chevron osteotomy could be an efficient and reliable operative option for severe hallux valgus with increased HVA.