The Scarf Osteotomy with Minimally Invasive Lateral Release for Treatment of Hallux Valgus Deformity Intermediate and Long-Term Results
The Scarf Osteotomy with Minimally Invasive Lateral Release for Treatment of Hallux Valgus Deformity Intermediate and Long-Term Results
复制标题
DOI：
10.2106/jbjs.n.00971
复制
发表时间：
2015-08-05
影响因子：
5.3
通讯作者：
Trnka, Hans-Joerg
中科院分区：
文献类型：
--
作者：
Bock, Peter;Kluger, Rainer;Trnka, Hans-Joerg
背景资料：鲜为人知的是，手术矫正拇外翻畸形的长期结果，特别是复发率和因素导致recursion.Methods：一百零八例（115英尺）谁接受了围巾截骨术，九十三例（九十三英尺）进行了检查，平均随访时间为124个月。术前和最终随访时的临床检查包括活动度评价、视觉模拟量表测量的疼痛和美国矫形足踝协会（AOFAS）评分。术后还评估了足踝结局评分（FAOS）。在术前、术后6周和最终随访时评价影像学数据。额外的放射学数据可用于同一患者队列的79例患者在平均27个月postoperatives.Results：中位总AOFAS评分从术前57分提高到95分，在最后一次随访。与术前相比，最终随访时的所有影像学测量值（拇趾外翻角[HVA]、跖骨间角[IMA]、跖骨远端关节角[DMAA]和籽骨位置）均显示出显著（p < 0.05）改善。最终随访时复发率（HVA ≥ 20度）为30%。我们无法确定复发是否会导致功能障碍或生活质量的后果。结论：10年后的复发率为30%，最终HVA越高，疼痛程度越高。未经验证的结果测量所施加的限制排除了关于HVA对功能或生活质量影响的结论。
Background: Little is known about the long-term results of surgical correction of hallux valgus deformity, in particular, the recurrence rate and factors leading to recurrence.Methods: Of one hundred and eight patients (115 feet) who underwent a Scarf osteotomy, ninety-three patients (ninety-three feet) were examined at an average duration of follow-up of 124 months. Clinical examination before surgery and at the time of final follow-up included an evaluation of range of motion, pain as measured with a visual analog scale, and American Orthopaedic Foot & Ankle Society (AOFAS) scores. The Foot and Ankle Outcome Score (FAOS) was also assessed postoperatively. Radiographic data were evaluated preoperatively, at six weeks postoperatively, and at the time of final follow-up. Additional radiographic data were available for seventy-nine patients of the same patient cohort at an average of twenty-seven months postoperatively.Results: The median overall AOFAS score improved from 57 points preoperatively to 95 points at the time of final follow-up. All radiographic measurements (hallux valgus angle [HVA], intermetatarsal angle [IMA], distal metatarsal articular angle [DMAA], and sesamoid bone position) showed significant (p < 0.05) improvement at the time of final follow-up compared with preoperatively. The rate of recurrence (an HVA of >= 20 degrees) at the time of final follow-up was 30%. We were unable to determine if recurrence resulted in functional impairment or consequences for quality of life.Conclusions: The recurrence rate after ten years was 30%, and a higher final HVA resulted in higher pain levels. The limitations imposed by nonvalidated outcome measures precluded conclusions about the influence of HVA on function or quality of life.