Abstract：
BACKGROUND: This study proposes a treatment algorithm based on the correction of symptomatic metatarsus adductus (MA) associated with hallux abducto-valgo (HAV) through tarsometatarsal joint 2-3 (TMTJ) shortening arthrodesis. Our hypothesis is that the proposed algorithm leads to realignment of the forefoot rays from two to five and reduction of the talonavicular coverage angle (TNCA) with good clinical and radiographic results.
METHODS: Clinical and radiographic evaluations were performed before and after surgery at 1-year follow-up on forty-six consecutive adult patients with MA, midfoot pain, HAV and osteoarthritis and/or instability of the TMTJ 2-3 in whom shortening of the 2nd and 3rd TMT joints according to MAA and treatment of the HV according to deformity was undertaken.
RESULTS: Talus-first metatarsal angle (TFMA) was the only parameter which did not statistically significantly postoperatively change. All other clinical (AOFAS score) and radiological outcomes significantly improved postoperatively.
CONCLUSIONS: Although further studies are needed to confirm the proposed data, it would seems that the shortening arthrodesis of rays two and three has consequences on the forefoot and hindfoot by realigning the longitudinal axis of the foot. The consequent application of the algorithm and adequate correction of the HAV allow good clinical and radiographic results to be obtained.
METHODS: IV prospective cases series.
METHODS: Clinical and radiographic evaluations were performed before and after surgery at 1-year follow-up on forty-six consecutive adult patients with MA, midfoot pain, HAV and osteoarthritis and/or instability of the TMTJ 2-3 in whom shortening of the 2nd and 3rd TMT joints according to MAA and treatment of the HV according to deformity was undertaken.
RESULTS: Talus-first metatarsal angle (TFMA) was the only parameter which did not statistically significantly postoperatively change. All other clinical (AOFAS score) and radiological outcomes significantly improved postoperatively.
CONCLUSIONS: Although further studies are needed to confirm the proposed data, it would seems that the shortening arthrodesis of rays two and three has consequences on the forefoot and hindfoot by realigning the longitudinal axis of the foot. The consequent application of the algorithm and adequate correction of the HAV allow good clinical and radiographic results to be obtained.
METHODS: IV prospective cases series.
摘要：
背景：这项研究提出了一种治疗算法，该算法基于通过2-3（TMTJ）缩短关节固定术来纠正与外展（HAV）相关的症状性meta骨内收（MA）。我们的假设是，所提出的算法导致前足射线从2个重新对齐到5个，并减少了距骨覆盖角（TNCA），并获得了良好的临床和影像学结果。
方法：对46例连续成年MA患者进行手术前后1年随访，进行临床和影像学评估。中足疼痛,TMTJ2-3的HAV和骨关节炎和/或不稳定性，其中根据MAA缩短了第二和第三TMT关节，并根据畸形进行了HV治疗。
结果：距骨第一跖骨角（TFMA）是术后无统计学意义的唯一参数。所有其他临床（AOFAS评分）和放射学结果均在术后显着改善。
结论：尽管还需要进一步的研究来确认建议的数据，看来，缩短关节固定术的射线二和三的后果，对前足和后足重新对齐的纵轴。算法的后续应用和HAV的适当校正可以获得良好的临床和影像学结果。
方法：IV前瞻性病例系列。
方法：对46例连续成年MA患者进行手术前后1年随访，进行临床和影像学评估。中足疼痛,TMTJ2-3的HAV和骨关节炎和/或不稳定性，其中根据MAA缩短了第二和第三TMT关节，并根据畸形进行了HV治疗。
结果：距骨第一跖骨角（TFMA）是术后无统计学意义的唯一参数。所有其他临床（AOFAS评分）和放射学结果均在术后显着改善。
结论：尽管还需要进一步的研究来确认建议的数据，看来，缩短关节固定术的射线二和三的后果，对前足和后足重新对齐的纵轴。算法的后续应用和HAV的适当校正可以获得良好的临床和影像学结果。
方法：IV前瞻性病例系列。
