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首页> 外文期刊>Foot and ankle international >Proximal spherical metatarsal osteotomy for the foot with severe hallux valgus.
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Proximal spherical metatarsal osteotomy for the foot with severe hallux valgus.

机译：严重的拇外翻足的近端球形osteo骨截骨术。

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BACKGROUND: A proximal spherical metatarsal osteotomy was devised to correct not only varus deviation of the first metatarsal, but also dorsiflexion. We expected to increase the medial longitudinal arch by adding plantar flexion at the osteotomy site. To investigate the limitations of this procedure for feet with severe hallux valgus, a followup study was performed on patients with preoperative hallux valgus angles greater than or equal to 40 degrees. MATERIALS AND METHODS: Forty-eight feet in 37 patients (10 male, 27 female) (60 years; range, 20 to 84 years) were investigated. Mean followup was 4 years and 1 month, ranging from 2 to 8 years. The spherical osteotomy was performed using a curved chisel. A distal soft tissue procedure was done at the same time. Twenty feet received combined operations for their combined deformities. RESULTS: While 81% of patients were satisfied with the results, 50% of those with preoperative hallux valgus angles greater than or equal to 50 degrees had postoperative hallux valgus angle greater than or equal to 20 degrees. In these patients, correction of metatarsus primus varus was good, but correction of valgus deviation of the hallux was fair. Mean correction toward plantar flexion was 1.5 degrees and no increase in arch height was achieved. CONCLUSION: The proximal spherical osteotomy could consistently achieve satisfactory results for the patients with hallux valgus angles less than 50 degrees. However, the corrections were worse in feet with more severe deformities. Furthermore, plantarflexion at the osteotomy site was offset by displacement at the first tarsometatarsal joint. If plantarflexion is indispensable, arthrodesis of the tarsometatarsal joint is recommended.
机译：背景：设计了一种近端球形meta骨截骨术，不仅可以矫正第一meta骨的内翻偏差，还可以矫正背屈。我们期望通过在截骨部位增加足底屈曲来增加内侧纵弓。为了研究该方法对患有严重拇外翻的脚的局限性，对术前拇外翻角大于或等于40度的患者进行了随访研究。材料与方法：调查了37例患者中48英尺（男10例，女27例）（60岁;范围20至84岁）。平均随访时间为4年零1个月，范围为2至8年。使用弯曲的凿子进行球形截骨术。同时进行远端软组织手术。 20英尺因合并畸形接受了联合手术。结果：81％的患者对结果满意，而术前拇外翻角大于或等于50度的患者中有50％术后拇外翻角大于或等于20度。在这些患者中，correction骨股骨内翻的矫正效果良好，但拇趾外翻偏离的矫正尚可。足底屈曲的平均矫正为1.5度，足弓高度没有增加。结论：对于拇外翻角度小于50度的患者，近端球形截骨术始终可以取得满意的效果。但是，畸形更严重的脚的矫正效果更差。此外，截骨部位的足底屈曲被第一骨joint关节的移位所抵消。如果足底屈曲是必不可少的，则建议睑板tar关节关节固定。

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