UNASSIGNED:外翻畸形的复发有多种原因,芝麻的不完全减少可能是重要的问题之一。然而,我们曾在前位(AP)立位X线片上看到数例术后外侧游离骨移位的患者,他们没有出现外翻复发.因此,我们假设AP站立X光片上的芝麻骨侧向移位不会导致外翻复发.
UNASSIGNED:该研究包括269英尺(185例)的外翻患者,他们接受了远端V形跖骨截骨术治疗。患者平均年龄为64.26(范围,15-80)年。患者平均随访33.85(范围,2002年4月至2019年12月之间的12-228)个月。将患者分为4组,根据有无外翻复发和芝麻骨减少。
未经授权:在门诊随访期间,我们在AP站立X光片上发现了99英尺(42.1%),尽管外侧芝麻骨移位(IV-VII级),但外翻没有复发。Hallux外翻角(HVA,2.7至7.9度),跖骨间角(IMA,4.6至6.2度),芝麻骨等级(2.1至3.5)在手术后都随着时间的推移而恶化,每个指标都发生了统计学上的显着变化,3个指标的变化具有统计学意义的正相关。随着时间的推移,在AP站立X射线照片上有和没有芝麻样减少的情况下,双脚之间的HVA和IMA变化增加,在最终随访时,HVA(2.9度)和IMA(0.9度)的差异显着(P<0.05)。无论在AP站立射线照片上是否实现了芝麻样减少,最终分析显示,两组的HVA和IMA均随时间恶化.Further,两组之间随时间的变化模式没有差异.
未经评估:在我们的队列中,根据影像学标准,AP站立X线照片上的术后籽骨位置与外翻复发无关.
未经批准:三级,回顾性比较研究。
Recurrence of the hallux valgus deformity has various causes, and the incomplete reduction of sesamoids may be one of the important issues. However, we have seen several patients with postoperative lateral sesamoid displacement on anteroposterior (AP) standing radiographs who did not experience hallux valgus recurrence. Therefore, we hypothesized that lateral displacement of the sesamoid on AP standing radiographs does not cause hallux valgus recurrence.
The study included 269 feet (185 patients) with hallux valgus treated with distal chevron metatarsal osteotomy. Mean patient age was 64.26 (range, 15-80) years. Patients were followed up for an average of 33.85 (range, 12-228) months between April 2002 and December 2019. The patients were divided into 4 groups, according to the presence or absence of hallux valgus recurrence and sesamoid reduction.
During outpatient follow-up, we discovered 99 feet (42.1%) in which hallux valgus did not recur despite lateral sesamoid displacement (grade IV-VII) on AP standing radiographs. Hallux valgus angle (HVA, 2.7 to 7.9 degrees), intermetatarsal angle (IMA, 4.6 to 6.2 degrees), and sesamoid grades (2.1 to 3.5) all deteriorated over time after surgery, and each indicator was statistically significantly altered, and changes in the 3 indicators had a statistically significant positive correlation. Changes in HVA and IMA between feet with and without sesamoid reduction on AP standing radiographs increased over time, with the differences in HVA (2.9 degrees) and IMA (0.9 degrees) being significant at final follow-up (P < .05 for each). Regardless of whether sesamoid reduction was achieved on AP standing radiographs, the final analysis showed that HVA and IMA in both groups worsened over time. Further, there were no differences between the 2 groups in the patterns of change over time.
In our cohort, postoperative sesamoid position on AP standing radiographs was not associated with hallux valgus recurrence based on radiographic criteria.
Level III, retrospective comparative study.