背景:微创手术(MIS),如微创人字形截骨术和Akin截骨术(MICA),在外翻治疗中已经变得很流行。然而,如何在MICA中有效而简单地纠正外翻的三维畸形仍然很困难。MICA中需要特殊设备,如之前报道的那样。减少MICA对专用设备的依赖是有意义和必要的。
方法:从2021年1月至2022年7月,对轻度或中度外翻患者采用MIS的Joy-stick辅助三维改良技术(Joy-stick3D技术)进行治疗。VAS,AOFASHalluxMTP-IP分数,外翻角(HVA),meta骨间角(IMA),在至少6个月的最后一次随访中,测量术前和术后的远台关节角(DMAA)。使用配对样本t检验比较得分和放射学角度。
结果:共纳入36例。HVA,IMA,DMAA为(22.3±6.1)°,(14.0±3.2)°,术前(8.9±3.2)°,减小至(7.0±1.8)°,(3.7±1.0)°,术后(3.3±1.1)°。VAS从4.3±1.7降至0.7±0.7。AOFASHalluxMTP-IP评分从68.6±7.6提高到92.9±6.1。比较轻度和中度病例,虽然HVA,IMA,和DMAA术前有显著差异,手术后角度在统计学上相似.
结论:提出了一种操纵杆辅助三维改良技术,以控制meta骨头部的三维位置并减少对特殊工具的依赖。使用Joy-stick3D技术可以有效地矫正轻度和中度的外翻畸形。
BACKGROUND: Minimally invasive surgery (MIS) such as minimally invasive chevron osteotomy and Akin osteotomy (MICA) has become popular in the treatment of hallux valgus. However, how to correct three-dimensional deformities in hallux valgus effectively and simply in MICA is still difficult. Special equipment is required in MICA as has been reported before. It is meaningful and necessary to reduce the reliance on special equipment in MICA.
METHODS: From January 2021 to July 2022, patients with mild or moderate hallux valgus were treated with a joy-stick assistant three-dimensional modified technique (Joy-stick 3D technique) of MIS. VAS, AOFAS Hallux MTP-IP scores, hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were measured pre- and postoperatively at the last follow-up of at least 6 months. Scores and radiologic angles were compared using paired sample t-test.
RESULTS: A total of 36 cases were included. HVA, IMA, and DMAA were (22.3 ± 6.1)°, (14.0 ± 3.2)°, and (8.9 ± 3.2)° preoperatively, and decreased to (7.0 ± 1.8)°, (3.7 ± 1.0)°, and (3.3 ± 1.1)° postoperatively. VAS decreased from 4.3 ± 1.7 to 0.7 ± 0.7. AOFAS Hallux MTP-IP scores improved from 68.6 ± 7.6 to 92.9 ± 6.1. Comparing mild and moderate cases, though HVA, IMA, and DMAA were significantly different preoperatively, the angles became statistically similar after surgery.
CONCLUSIONS: A joy-stick assistant three-dimensional modified technique is proposed to control the three-dimensional position of the metatarsal head and to reduce dependence on special tools. Mild and moderate hallux valgus deformities are effectively corrected using Joy-stick 3D technique.