중등도 무지 외반증 환자에서 원위부 갈매기형 절골술과 중족골 근위부 폐쇄성 쐐기 절골술의 치료 결과 비교
Comparison of the Results between Distal Chevron Osteotomy and Proximal Metatarsal Osteotomy for the Treatment of Moderate Hallux Valgus
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Purpose: The purpose of this study is to compare the treatment outcomes of distal chevron osteotomy with those of proximal metatarsal closing wedge osteotomy in patients with moderate severity hallux valgus. Materials and Methods: Forty-two patients (51 feet) who were underwent either distal chevron osteotomy (Group I, 22 patients, 27 feet) or proximal metatarsal closing wedge osteotomy (Group II, 20 patients, 24 feet) for the correction of moderate hallux valgus deformity were evaluated retrospectively. We assessed the radiographic results with several parameters including hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). And clinical results with modified AOFAS score at last follow-up. Results: There were no significant differences in IMA, HVA and DMAA between two groups preoperatively. We can achieve the good results with both procedures, but mean HVA and IMA of group II was significantly lower than those of group I. There was some loss of correction in group I at the last follow-up. There was no significant difference in clinical results according to modified AOFAS scoring between two groups at the last follow-up. Conclusion: The proximal metatarsal closing wedge osteotomy for the hallux valgus with moderate severity is better treatment option to achieve better radiographic correction and to prevent loss of correction or recurrence than distal chevron osteotomy.
Abstract
Purpose: The purpose of this study is to compare the treatment outcomes of distal chevron osteotomy with those of proximal metatarsal closing wedge osteotomy in patients with moderate severity hallux valgus. Materials and Methods: Forty-two patients (51 feet) who were underwent either distal chevron osteotomy (Group I, 22 patients, 27 feet) or proximal metatarsal closing wedge osteotomy (Group II, 20 patients, 24 feet) for the correction of moderate hallux valgus deformity were evaluated retrospectively. We assessed the radiographic results with several parameters including hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). And clinical results with modified AOFAS score at last follow-up. Results: There were no significant differences in IMA, HVA and DMAA between two groups preoperatively. We can achieve the good results with both procedures, but mean HVA and IMA of group II was significantly lower than those of group I. There was some loss of correction in group I at the last follow-up. There was no significant difference in clinical results according to modified AOFAS scoring between two groups at the last follow-up. Conclusion: The proximal metatarsal closing wedge osteotomy for the hallux valgus with moderate severity is better treatment option to achieve better radiographic correction and to prevent loss of correction or recurrence than distal chevron osteotomy.
참고문헌 (18)
- Barouk LS, "Osteotomie scarf du premier metatarsien", Med Chir Pied, 10, pp.111~120 (1994)
- Coughlin MJ, "Chevron procedure", Contemp Orthop, 23, pp.45~49 (1991)
- Coughlin MJ, "Adult hallux valgus. In: Surgery of the foot and ankle. 7th ed.", pp.150~269 (1999), Mosby-year book
- Crosby LA, "Fixation comparison for chevron osteotomies", Foot Ankle Int, 19, pp.41~43 (1998)
- Easley ME, "Prospective randomized comparison of proximal crescentic and proximal chevron osteotomies for correction of hallux valgus deformity", Foot Ankle Int, 17, pp.307~316 (1996)
- Glynn MK, "The Mitchell distal metatarsal osteotomy for hallux valgus", J Bone Joint Surg, 62(B), pp.188~191 (1980)
- Klosok JK, "Chevron or Wilson metatarsal osteotomy for hallux valgus. A prospective randomized trial", J Bone Joint Surg, 75(B), pp.825~829 (1993)
- Mann RA, "Complications associated with the Chevron osteotomy", Foot Ankle, 3, pp.125~129 (1982)
- Mann RA, "Hallux valgus", Instr Course Lect, 35, pp.339~353 (1986)
- Markbreiter LA, "Proximal metatarsal osteotomy in hallux valgus correction: a comparison of crescentic and chevron procedures", Foot Ankle Int, 18통권 : 7, pp.71~76 (1997)
- Meier PJ, "The risks and benefits of distal first metatarsal osteotomies", Foot Ankle, 6, pp.7~17 (1985)
- Miller JW, "Distal first metatarsal displacement osteotomy", J Bone Joint Surg, 56(A), pp.923~931 (1974)
- Okuda R, "Distal soft tissue procedure and proximal metatarsal osteotomy in hallux valgus", Clin Orthop Relat Res, 379, pp.209~217 (2000)
- Resch S, "Proximal closing wedge osteotomy and adductor tenotomy for treatment of hallux valgus", Foot Ankle, 9, pp.272~280 (1989)
- Resch S, "Circulatory disturbance of the first metatarsal head after Chevron osteotomy as shown by bone scintigraphy", Foot Ankle, 13, pp.137~142 (1992)
- Sammarco GJ, "Bunion correction using proximal Chevron osteotomy", Foot Ankle, 14, pp.8~14 (1993)
- Sammarco VJ, "Surgical correction of moderate and severe hallux valgus: proximal metatarsal osteotomy with distal soft-tissue correction and arthrodesis of the metatarsophalangeal joint", Instr Course Lect, 57, pp.415~428 (2008)
- Yoon JO, "Distal chevron osteotomy for the treatment of moderate and severe hallux valgus", J Korean Foot Ankle Soc, 7, pp.166~173 (2003)