Minimally Invasive Distal Metatarsal Osteotomy for Mild-To-Moderate Hallux Valgus Deformity

近年來，微創手術在足踝手術領域漸趨發展，其中當然包括應用於大腳趾外翻。我們研究的目的，乃針對輕至中度大腳趾外翻施行微創遠端蹠骨切骨手術，並對其治療結果及預後進行分析。從2005年9月至2006年12月，共有31位輕度至中度大腳趾外翻的病人（共47隻腳）接受微創切骨手術。我們根據其臨床及影像結果來評估。在臨床上，病人滿意度達90.32%，而美國足踝學會功能量表平均分數有92.7分。併發症包括2例術後關節僵硬，6例鋼釘傷口感染，僅1例深部感染，並沒有發現切骨處未癒合、癒合不良、過度矯正、轉移性蹠骨疼痛及骨缺血性壞死等問題。在X光影像上，大腳趾外翻角度及第一蹠骨間角度分別可被矯正11.8度及6.3度，和手術前比較具統計上顯著性差異。因此，我們的微創切骨手術不僅能達到良好的滿意度及功能，並且有低併發症發生率，對於輕至中度大腳趾外翻而言，確實是個有效、安全且簡單的治療方法。

關鍵字

大腳趾外翻；微創

並列摘要

Minimally invasive surgery has recently been introduced for foot and ankle surgery, and hallux valgus surgery is no exception. The purpose of our study was to analyze the early results and to present our experience of minimally invasive distal metatarsal osteotomy in correcting mild-tomoderate hallux valgus deformities. Between September 2005 and December 2006, 31 consecutive patients (47 feet) with mild-to-moderate hallux valgus deformities underwent minimally invasive distal metatarsal osteotomies. The clinical and radiographic outcomes were assessed. The satisfaction rate was 90.32%. The mean total American Orthopedic Foot and Ankle Society halluxmetatarsophalangeal- interphalangeal scale was 92.7 points. Complications included two (4.26%) episodes of stiffness, six (12.77%) episodes of pin tract infection, and one (2.13%) deep infection. There were no cases with nonunion, malunion, overcorrection, transfer metatarsalgia or osteonecrosis. On weight-bearing anteroposterior foot radiographs, the mean hallux valgus angle and first intermetatarsal angle corrections were 11.8° and 6.3°, respectively, which is a statistically significant difference (p ＜ 0.001) between the preoperative and postoperative status. Here, minimally invasive distal metatarsal osteotomy was associated with good satisfaction, functional improvement and low complication rates. This technique offers an effective, safe and simple way to treat hallux valgus with a first intermetatarsal angle less than 15°.

並列關鍵字

hallux valgus ； minimally invasive

國際替代計量

Minimally Invasive Distal Metatarsal Osteotomy for Mild-To-Moderate Hallux Valgus Deformity

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