중등도 무지외반증에서 시행한 단축 스카프 절골술
Short Scarf Osteotomy for Moderate Hallux Valgus
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: The aim of this study was to evaluate the radiographic and clinical results of short scarf osteotomy that has minimized longitudinal cut for moderate hallux valgus. Materials and Methods: Total 12 patients (12 feet) were reviewed by medical records and radiographs. All patients were female and the mean age at the time of operation was 41.5 years. The mean followup time was 21.2 months. We modified original scarf osteotomy by shortening the longitudinal cut to 15~20 mm in length. Additionally, Akin osteotomy of the first proximal phalanx was done in 7 feet and Weil osteotomy of the second metatarsal was done in 4 feet. First-second intermetatarsal and hallux valgus angles were analyzed radiographically before and after the operation. And the clinical result was assessed by AOFAS (American Orthopaedic Foot and Ankle Society) hallux score. Results: First-second intermetatarsal and hallux valgus angles were reduced from the mean preoperative values of 14.6˚and 32.8˚to 6.5˚and 11.2˚, respectively. The mean AOFAS hallux score was increased from 52.4 points preoperatively to 88.2points at followup. Three complications were found: metatarsal fracture during the operation, painful scar around second metatarsal head after Weil osteotomy and postoperative neuralgia. There was no transfer metatarsalgia or recurrence of hallux valgus during followup. Conclusion: Short scarf osteotomy would be an effective surgical procedure for moderate hallux valgus with the benefits of minimized soft tissue dissection and stable fixation.
Abstract
Purpose: The aim of this study was to evaluate the radiographic and clinical results of short scarf osteotomy that has minimized longitudinal cut for moderate hallux valgus. Materials and Methods: Total 12 patients (12 feet) were reviewed by medical records and radiographs. All patients were female and the mean age at the time of operation was 41.5 years. The mean followup time was 21.2 months. We modified original scarf osteotomy by shortening the longitudinal cut to 15~20 mm in length. Additionally, Akin osteotomy of the first proximal phalanx was done in 7 feet and Weil osteotomy of the second metatarsal was done in 4 feet. First-second intermetatarsal and hallux valgus angles were analyzed radiographically before and after the operation. And the clinical result was assessed by AOFAS (American Orthopaedic Foot and Ankle Society) hallux score. Results: First-second intermetatarsal and hallux valgus angles were reduced from the mean preoperative values of 14.6˚and 32.8˚to 6.5˚and 11.2˚, respectively. The mean AOFAS hallux score was increased from 52.4 points preoperatively to 88.2points at followup. Three complications were found: metatarsal fracture during the operation, painful scar around second metatarsal head after Weil osteotomy and postoperative neuralgia. There was no transfer metatarsalgia or recurrence of hallux valgus during followup. Conclusion: Short scarf osteotomy would be an effective surgical procedure for moderate hallux valgus with the benefits of minimized soft tissue dissection and stable fixation.
참고문헌 (18)
- Robinson AH, "Prospective comparative study of the scarf and Ludloff osteotomies in the treatment of hallux valgus", Foot Ankle Int, 30(10), pp.955~963 (2009)
- Coughlin MJ, "Hallux valgus in men. Part II: First ray mobility after bunionectomy and factors associated with hallux valgus deformity", Foot Ankle Int, 24(1), pp.73~78 (2003)
- Aminian A, "Scarf osteotomy for hallux valgus deformity : an intermediate followup of clinical and radiographic outcomes", Foot Ankle Int, 27(11), pp.883~886 (2006)
- Kristen KH, "The SCARF osteotomy for the correction of hallux valgus deformities", Foot Ankle Int, 23(3), pp.221~229 (2002)
- Lipscombe S, "Scarf osteotomy for the correction of hallux valgus : midterm clinical outcome", J Foot Ankle Surg, 47(4), pp.273~277 (2008)
- Weinraub GM, "Vascular perfusion of the long dorsal arm versus chevron osteotomy : a cadaveric injection study", J Foot Ankle Surg, 43(4), pp.221~224 (2004)
- Malal JJ, "Blood supply to the first metatarsal head and vessels at risk with a chevron osteotomy", J Bone Joint Surg Am, 89(9), pp.2018~2022 (2007)
- Thordarson D, "Correlation of hallux valgus surgical outcome with AOFAS forefoot score and radiological parameters", Foot Ankle Int, 26(2), pp.122~127 (2005)
- Hardy RH, "Observations on hallux valgus; based on a controlled series", J Bone Joint Surg Br, 33(3), pp.376~391 (1951)
- Coetzee JC, "Scarf osteotomy for hallux valgus repair : the dark side", Foot Ankle Int, 24(1), pp.29~33 (2003)
- Caminear DS, "Fixation of the chevron osteotomy with an absorbable copolymer pin for treatment of hallux valgus deformity", J Foot Ankle Surg, 44(3), pp.203~210 (2005)
- Barca F, "Austin", chevron osteotomy fixed with bioabsorbable poly-L-lactic acid single screw, 1997, pp.36(1), 15~20
- Markus TA, "Modifications of the distal metaphyseal osteotomy to better facilitate use of the Herbert bone screw for fixation", J Foot Surg, 27(5), pp.447~452 (1988)
- Rockett MS, "Midshaft first-ray osteotomies for hallux valgus", Clin Podiatr Med Surg, 22(2), pp.169~195 (2005)
- Smith SE, "Scarf versus chevron osteotomy for the correction of 1-2 intermetatarsal angle in hallux valgus : a systematic review and meta-analysis", J Foot Ankle Surg, 51(4), pp.437~444 (2012)
- Bai LB, "Distal chevron osteotomy with distal soft tissue procedure for moderate to severe hallux valgus deformity", Foot Ankle Int, 31(8), pp.683~688 (2010)
- Deenik A, "Equivalent correction in scarf and chevron osteotomy in moderate and severe hallux valgus : a randomized controlled trial", Foot Ankle Int, 29(12), pp.1209~1215 (2008)
- Deenik AR, "Scarf versus chevron osteotomy in hallux valgus : a randomized controlled trial in 96 patients", Foot Ankle Int, 28(5), pp.537~541 (2007)
