PDF(Pubmed)
Abstract：
UNASSIGNED: Recognizing preoperative first-ray hypermobility is important to planning hallux valgus (HV) surgery. A recent study showed the minimally invasive chevron Akin (MICA) osteotomy increased varus displacement of the proximal fragment of the first metatarsal osteotomy. The present study aims to evaluate the ability of the radiographic first-ray squeeze test to predict the varus displacement of the proximal fragment of the first metatarsal osteotomy when performing the MICA procedure.
UNASSIGNED: A prospective case series of patients with moderate to severe HV who underwent MICA was performed. The HV deformity correction was analyzed by comparing the preoperative and 12-week postoperative hallux valgus angle (HVA) and the intermetatarsal angle between the first and second rays (1-2 IMA). The ability of the radiographic first-ray squeeze test to predict the varus displacement of the first metatarsal was done by comparing the preoperative 1-2 IMA measured in the AP radiographic first-ray squeeze test (IMA-ST) with the intermetatarsal angle between the second metatarsal and the axis of the first metatarsal osteotomy proximal fragment (IAPF) taken 12 weeks postoperatively.
UNASSIGNED: Between July 2022 and May 2023, a total of 39 feet in 28 patients underwent MICA. The mean IMA improved from 13.8 (SD = 2.2) to 3.8 degrees (SD = 1.5) (P < .001), and the mean HVA improved from 27.8 (SD = 6.1) to 4.9 degrees (SD = 2.5) (P < .001). A linear regression analysis revealed that IMA-ST is highly associated with the 12 week assessed IAPF (P < .001).
UNASSIGNED: The preoperative radiographic first-ray squeeze test appears to predict with high fidelity the varus displacement of the proximal fragment of the first metatarsal that can occur after the MICA procedure.Level of Evidence: Level III, prospective cohort study.
UNASSIGNED: A prospective case series of patients with moderate to severe HV who underwent MICA was performed. The HV deformity correction was analyzed by comparing the preoperative and 12-week postoperative hallux valgus angle (HVA) and the intermetatarsal angle between the first and second rays (1-2 IMA). The ability of the radiographic first-ray squeeze test to predict the varus displacement of the first metatarsal was done by comparing the preoperative 1-2 IMA measured in the AP radiographic first-ray squeeze test (IMA-ST) with the intermetatarsal angle between the second metatarsal and the axis of the first metatarsal osteotomy proximal fragment (IAPF) taken 12 weeks postoperatively.
UNASSIGNED: Between July 2022 and May 2023, a total of 39 feet in 28 patients underwent MICA. The mean IMA improved from 13.8 (SD = 2.2) to 3.8 degrees (SD = 1.5) (P < .001), and the mean HVA improved from 27.8 (SD = 6.1) to 4.9 degrees (SD = 2.5) (P < .001). A linear regression analysis revealed that IMA-ST is highly associated with the 12 week assessed IAPF (P < .001).
UNASSIGNED: The preoperative radiographic first-ray squeeze test appears to predict with high fidelity the varus displacement of the proximal fragment of the first metatarsal that can occur after the MICA procedure.Level of Evidence: Level III, prospective cohort study.
摘要：
■认识到术前一线光线的过度移动对于计划外翻（HV）手术很重要。最近的一项研究表明，微创人字形（MICA）截骨术增加了第一meta骨截骨术近端碎片的内翻移位。本研究旨在评估进行MICA手术时，射线照相第一射线挤压试验预测第一meta骨切开术近端骨折内翻移位的能力。
■对接受MICA的中度至重度HV患者进行了前瞻性病例系列研究。通过比较术前和术后12周的外翻角（HVA）以及第一和第二射线（1-2IMA）之间的meta骨间角，分析了HV畸形的矫正。通过比较在AP射线照相第一射线挤压试验（IMA-ST）中测得的术前1-2IMA与在术后12周进行的第二meta骨和第一meta骨截骨碎片（IAPF）的轴之间的meta骨间角，可以得出射线照相第一射线挤压试验预测第一meta骨内翻移位的能力。
■在2022年7月至2023年5月之间，共有28名患者的39英尺接受了MICA。平均IMA从13.8度(SD=2.2)提高到3.8度(SD=1.5)(P<.001),平均HVA从27.8度(SD=6.1)提高到4.9度(SD=2.5)(P<.001)。线性回归分析显示IMA-ST与12周评估的IAPF高度相关(P<.001)。
■术前射线照相第一射线挤压试验似乎可以高保真度地预测MICA手术后可能发生的第一meta骨近端碎片的内翻移位。证据级别：三级，前瞻性队列研究。
■对接受MICA的中度至重度HV患者进行了前瞻性病例系列研究。通过比较术前和术后12周的外翻角（HVA）以及第一和第二射线（1-2IMA）之间的meta骨间角，分析了HV畸形的矫正。通过比较在AP射线照相第一射线挤压试验（IMA-ST）中测得的术前1-2IMA与在术后12周进行的第二meta骨和第一meta骨截骨碎片（IAPF）的轴之间的meta骨间角，可以得出射线照相第一射线挤压试验预测第一meta骨内翻移位的能力。
■在2022年7月至2023年5月之间，共有28名患者的39英尺接受了MICA。平均IMA从13.8度(SD=2.2)提高到3.8度(SD=1.5)(P<.001),平均HVA从27.8度(SD=6.1)提高到4.9度(SD=2.5)(P<.001)。线性回归分析显示IMA-ST与12周评估的IAPF高度相关(P<.001)。
■术前射线照相第一射线挤压试验似乎可以高保真度地预测MICA手术后可能发生的第一meta骨近端碎片的内翻移位。证据级别：三级，前瞻性队列研究。
