The effect of first ray shortening in the development of metatarsalgia in the second through fourth rays after metatarsal osteotomy
The effect of first ray shortening in the development of metatarsalgia in the second through fourth rays after metatarsal osteotomy
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DOI：
10.3113/fai.2007.0011
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发表时间：
2007-01-01
影响因子：
2.7
通讯作者：
Rode, Laszlo
中科院分区：
文献类型：
--
作者：
Toth, Kalman;Huszanyik, Istvan;Rode, Laszlo
背景资料：本研究的目的是确定缩短第一排矫正拇外翻畸形后第二至第五排跖骨痛的严重程度和患者对美容效果的满意度。研究方法：术后4.19 +/- 1.29年对240例跖骨截骨术（Lindgren和Turan改良的Wilson截骨术）进行了评价。手术包括第一跖骨头下轻微倾斜截骨术和一枚螺钉固定。结果如下：拇外翻角平均减少26.5 °，12跖骨间角平均减少8.4 ± 4 °，第一跖骨平均缩短3.8 ± 1.8mm，第二至第四跖骨疼痛与第一跖骨短缩呈正相关（p < 0.001第二条射线，p < 0.001第三条射线，p < 0.001第四条射线）;第五条射线和第一条射线之间没有相关性。在第二至第五射线中，没有发现拇趾外翻角或1-2跖骨间角的减小与跖骨痛之间的相关性。术后足对线与拇外翻减少呈正相关（p < 0.001），术后足对线与第一条桡骨短缩呈负相关（p < 0.01）。术后足部对线与1-2跖骨间角之间没有相关性。结论：第一跖骨移植术后应避免过度短缩，以减少术后疼痛的发生。我们发现，患者对足对线的满意度更高，患者的拇趾外翻角度下降更大，第一条线缩短更少。
Background: The aims of this study were to determine the severity of metatarsalgia of the second through fifth rays after shortening of the first ray for correction of hallux valgus deformity and patient satisfaction of the cosmetic results. Methods: Two hundred and forty metatarsal osteotomies (Wilson osteotomy as modified by Lindgren and Turan) were evaluated 4.19 +/- 1.29 years postoperatively. The procedure involved a slightly oblique subcapital osteotomy of the first metatarsal and fixation with one screw. Results: The average decrease in the hallux valgus angle was 26 5 degrees, the 12 intermetatarsal angle was 8.4 +/- 4 degrees, and the average shortening of the first metatarsal was 3.8 +/- 1.8 mm. Positive correlations were found between metatarsalgia of the second through fourth rays and first ray shortening (p < 0.001 second ray, p < 0.001 third ray, and p < 0.001 fourth ray); there was no correlation between the fifth ray and first ray shortening. No correlation was found between a decrease in the hallux valgus angle or 1-2 intermetatarsal angle and metatarsalgia in the second through fifth rays. A positive correlation was detected between postoperative foot alignment and decrease in the hallux valgus (p < 0.001) and a negative correlation between postoperative foot alignment and first ray shortening (p < 0.01). No correlation was noted between postoperative foot alignment and the 1-2 intermetatarsal angle. Conclusion: Excessive shortening of the first metatarsal should be avoided to decrease the occurrence of postoperative transfer metatarsalgia. We found a greater patient satisfaction with foot alignment in patients who had a greater decrease in the hallux valgus angle and less shortening of the first ray.