고도의 무지 외반증에서 역갈매기형 중족골 절골술 및 Akin 절골술의 치료
Treatment of Severe Hallux Valgus Deformity with Proximal Reverse Chevron Metatarsal Osteotomy and Akin Osteotomy
대한족부족관절학회지 2010년 14권 1호 p.16 ~ p.20
정홍근:Jung Hong-Geun
오정환:Oh Jeong-Hwan/김태훈:Kim Tae-Hoon/박재용:Park Jae-Yong/강민석:Kang Min-Seok
Abstract
Purpose: This study analyzed the clinical and radiographic outcome of the severe hallux valgus corrected with proximal reverse chevron metatarsal osteotomy and Akin osteotomy.
Materials and Methods: The study was based on 18 feet (15 patients) of severe hallux valgus (hallux valgus angle≥40° or intermetatarsal angle≥18°) treated with proximal reverse chevron metatarsal osteotomy and followed for more than 1 year. Akin osteotmy was added in 72% of the patients. Clinically preoperative and postoperative AOFAS Hallux Metatarsophalangeal - interphalangeal score, VAS pain score and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, hallux valgus interphalangeal angle, the intermetatarsal angle and sesamoid position before and after the operation were analyzed.
Results: AOFAS Hallux Metatarsophalangeal - interphalangeal score improved from 54.5 (25-78) to 87.7 (70-100) and VAS pain score decreased from 6.0 (3-8) to postoperative 1.2 (0-5). Ninety-six percents of the patients were satisfied with results. Radiologically hallux valgus angle was decreased from 43.3°(31-58°) preoperatively to 6.8° (-8-27°) postoperatively. The intermetatarsal angle was decreased from 18.4°(11-24°) preoperatively to 5.3° (1-12°) postoperatively. The sesamoid subluxation was improved from 2.8±0.4 preoperatively to 0.4±0.6 postoperatively.
Conclusion: Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.
키워드
Severe hallux valgus, Proximal reverse chevron metatarsal osteotomy, Akin osteotomy
KMID :
1130920100140010016
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유효성결과(Recomendation)
Proximal reverse chevron metatarsal osteotomy and lateral soft tissue release with additional Akin osteotomy is good treatment option for severe hallux valgus.