Abstract：
OBJECTIVE: The main purpose of our study was to evaluate satisfaction, recurrence, bone union and other complications after a minimum of two years follow-up in patients who had percutaneous claw and hammer (CHT) second toe correction utilizing a novel distal and bicortical proximal phalanx osteotomy (DBPPO).
METHODS: A minimum two-year follow-up prospective cohort study was conducted on consecutive patients with symptomatic CHT deformities of the second toe corrected with percutaneous surgery. Primary outcomes included satisfaction, recurrence, bony union, and other complication rates specific to the second toe deformity correction. Secondary outcomes included Metatarsophalangeal-Interphalangeal AOFAS scale and Visual Analogue Scale (VAS).
RESULTS: Between January and October 2020, 34 patients (43 feet) were clinically and radiologically evaluated pre and postoperatively at a mean of 26.6 months. Thirty-eight feet (88.4 %) were satisfied or very satisfied with their second toe deformity correction and 41 feet (95.3 %) would undergo surgery on this toe again. No deformity recurrence requiring revision was found. There were two complications (4.7 %): one toe (2.3 %) with persistent numbness and one (2.3 %) had a simple infection that resolved with oral antibiotics. All 43 s toe osteotomies demonstrated bony consolidation. Stiffness was reported in nine second toes (20.9 %), seven of them (77.8 %) having a rigid pre-operative deformity. Secondary outcomes demonstrated significant improvement in the mean ( ± standard deviation) AOFAS score which increased from 47.5 ± 17.9 preoperatively to 95.7 ± 7.7 postoperatively (p < .001). Mean VAS significantly improved from 4.9 ± 2.5 preoperatively to 0.3 ± 1.3 postoperatively (p < .001).
CONCLUSIONS: Percutaneous treatment of claw and hammer second toe deformities utilizing a DBPPO resulted in high levels of satisfaction with bony consolidation, no recurrence and low complication rates at two years follow-up.
METHODS: Level II - Prospective cohort study.
METHODS: A minimum two-year follow-up prospective cohort study was conducted on consecutive patients with symptomatic CHT deformities of the second toe corrected with percutaneous surgery. Primary outcomes included satisfaction, recurrence, bony union, and other complication rates specific to the second toe deformity correction. Secondary outcomes included Metatarsophalangeal-Interphalangeal AOFAS scale and Visual Analogue Scale (VAS).
RESULTS: Between January and October 2020, 34 patients (43 feet) were clinically and radiologically evaluated pre and postoperatively at a mean of 26.6 months. Thirty-eight feet (88.4 %) were satisfied or very satisfied with their second toe deformity correction and 41 feet (95.3 %) would undergo surgery on this toe again. No deformity recurrence requiring revision was found. There were two complications (4.7 %): one toe (2.3 %) with persistent numbness and one (2.3 %) had a simple infection that resolved with oral antibiotics. All 43 s toe osteotomies demonstrated bony consolidation. Stiffness was reported in nine second toes (20.9 %), seven of them (77.8 %) having a rigid pre-operative deformity. Secondary outcomes demonstrated significant improvement in the mean ( ± standard deviation) AOFAS score which increased from 47.5 ± 17.9 preoperatively to 95.7 ± 7.7 postoperatively (p < .001). Mean VAS significantly improved from 4.9 ± 2.5 preoperatively to 0.3 ± 1.3 postoperatively (p < .001).
CONCLUSIONS: Percutaneous treatment of claw and hammer second toe deformities utilizing a DBPPO resulted in high levels of satisfaction with bony consolidation, no recurrence and low complication rates at two years follow-up.
METHODS: Level II - Prospective cohort study.
摘要：
目的：我们研究的主要目的是评估满意度，复发,对采用新型远端和双皮质近端指骨截骨术(DBPPO)进行经皮爪和锤击(CHT)第二趾矫正的患者进行至少两年随访后的骨愈合和其他并发症。
方法：对经皮手术矫正第二脚趾有症状的CHT畸形的连续患者进行了至少两年的随访前瞻性队列研究。主要结果包括满意度，复发,骨性工会,以及第二脚趾畸形矫正的其他并发症发生率。次要结果包括meta趾-指间AOFAS量表和视觉模拟量表（VAS）。
结果：在2020年1月至10月之间，对34例患者（43英尺）进行了术前和术后平均26.6个月的临床和放射学评估。38英尺（88.4％）对第二次脚趾畸形矫正感到满意或非常满意，而41英尺（95.3％）将再次对该脚趾进行手术。未发现需要翻修的畸形复发。有两种并发症（4.7％）：一个脚趾（2.3％）持续麻木，一个脚趾（2.3％）简单感染，口服抗生素解决。所有43个脚趾截骨术均显示骨性巩固。在九个第二脚趾（20.9％）中报告了僵硬度，其中7人(77.8%)有刚性术前畸形。次要结果显示AOFAS评分的平均值（±标准差）显著改善，从术前的47.5±17.9增加到术后的95.7±7.7（p<.001）。平均VAS从术前的4.9±2.5显著改善至术后的0.3±1.3(p<.001)。
结论：使用DBPPO经皮治疗爪和锤状第二趾畸形可提高骨巩固的满意度。在两年的随访中没有复发和低并发症发生率。
方法：II级-前瞻性队列研究。
方法：对经皮手术矫正第二脚趾有症状的CHT畸形的连续患者进行了至少两年的随访前瞻性队列研究。主要结果包括满意度，复发,骨性工会,以及第二脚趾畸形矫正的其他并发症发生率。次要结果包括meta趾-指间AOFAS量表和视觉模拟量表（VAS）。
结果：在2020年1月至10月之间，对34例患者（43英尺）进行了术前和术后平均26.6个月的临床和放射学评估。38英尺（88.4％）对第二次脚趾畸形矫正感到满意或非常满意，而41英尺（95.3％）将再次对该脚趾进行手术。未发现需要翻修的畸形复发。有两种并发症（4.7％）：一个脚趾（2.3％）持续麻木，一个脚趾（2.3％）简单感染，口服抗生素解决。所有43个脚趾截骨术均显示骨性巩固。在九个第二脚趾（20.9％）中报告了僵硬度，其中7人(77.8%)有刚性术前畸形。次要结果显示AOFAS评分的平均值（±标准差）显著改善，从术前的47.5±17.9增加到术后的95.7±7.7（p<.001）。平均VAS从术前的4.9±2.5显著改善至术后的0.3±1.3(p<.001)。
结论：使用DBPPO经皮治疗爪和锤状第二趾畸形可提高骨巩固的满意度。在两年的随访中没有复发和低并发症发生率。
方法：II级-前瞻性队列研究。
