Abstract：
Hallux valgus (HV) is a common deformity of the foot. Its postoperative recurrence is not uncommon and is closely related to the recurrence of its underlying metatarsus primus varus (MPV) deformity. The syndesmosis procedure uses 1 to 2 intermetatarsal cerclage sutures to realign the first metatarsal and then induces a biological bonding between the 2 metatarsals to prevent the MPV deformity from recurring. This radiological study aimed to assess its effectiveness in long-term MPV and HV deformities recurrence prevention. Ninety-two feet of 51 consecutive patients had syndesmosis procedures that were prospectively followed up for more than 1 y and up to 14 y, averaging 100.5 (SD 45.2) months. Patients underwent X-ray examinations regularly at fixed intervals of their feet. We used Hardy\'s methods in measuring the intermetatarsal angle (IMA), hallux valgus angle (HVA), and medial sesamoid position from standing foot X-rays. More than 450 relevant X-ray and photo images were submitted as Supplementary Material for online viewing and reference. There was a significant final correction of IMA from 14.30° (SD 2.70) to 6.70° (SD 1.75) (p < .0001). There was no significant increase in IMA after the sixth postoperative month to their final follow-up endpoints, regardless of their lengths. There was a significant final correction of HVA from 31.95° (SD 7.45) to 19.1° (SD 7.45) (p < .0001). This study reconfirmed past findings that the MPV deformity could be corrected without osteotomies. Creating a syndesmosis-like intermetatarsal bonding was effective for long-term MPV recurrence prevention. Three feet had postoperative stress fracture of the second metatarsal. However, the HV deformity correction was less satisfactory, and the reasons were explained.
摘要：
hallux外翻（HV）是一种常见的足部畸形。其术后复发并不少见，并与其潜在的meta状前内翻（MPV）畸形的复发密切相关。联合手术使用1-2个meta骨间环扎缝线重新对齐第一meta骨，然后在两个meta骨之间诱导生物结合，以防止MPV畸形复发。这项放射学研究旨在评估其在长期MPV和HV畸形复发预防中的有效性。51名连续患者中的92英尺接受了联合手术，前瞻性随访了一年以上，长达14年，平均100.5(标准差45.2)个月。患者以固定的脚间隔定期进行X射线检查。我们使用Hardy的方法来测量meta骨间角（IMA），外翻角(HVA),站脚X光片的内侧籽骨位置。超过450张相关X射线和照片图像作为补充材料提交，供在线查看和参考。IMA从14.30°(SD2.70)到6.70°(SD1.75)存在显著的最终校正(p<0.0001)。术后第六个月至最终随访终点后，IMA没有显着增加，不管他们的长度。HVA从31.95°(SD7.45)到19.1°(SD7.45)存在显著的最终校正(p<0.0001)。这项研究再次证实了过去的发现，即MPV畸形可以在没有截骨术的情况下得到纠正。建立骨膜结合样的meta骨间键合对于长期预防MPV复发是有效的。三足有第二跖骨术后应力性骨折。然而,HV畸形矫正不太令人满意，并解释了原因。证据级别：二级，治疗研究。
