중등도 및 중증의 무지 외반증에서 Akin 절골술동반 유무에 따른 원위부 갈매기형 절골술의 수술결과 비교
Comparison of Operative Results of Distal Chevron Osteotomy with and without Akin Osteotomy for Moderate to Severe Hallux Valgus
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초록
Purpose: This study was conducted among patients with moderate to severe hallux valgus who underwent distal chevron osteotomyand groups of patients with or without Akin osteotomy were compared for evaluation of the relationship between their radiological andclinical outcomes. Materials and Methods: From January 2009 to January 2012, among patients with moderate to severe hallux valgus who underwentdistal chevron osteotomy at our institution, 28 cases with additional Akin osteotomy and 35 cases without Akin osteotomy available tofollow up of more than one year were included in this study. For radiologic evaluation, hallux valgus angle, 1, 2 intermetatarsal angle,and hallux interphalangeal angle were measured before and after surgery. For clinical assessment, visual analogue scale score, AmericanOrthopaedic Foot and Ankle Society score, subjective satisfaction of the patients, and passive range of motion of the first metatarsophalangealjoints were evaluated. Results: At the final follow up, correction of valgus hallux angle and 1, 2 intermetatarsal angle was obtained from radiation results ofboth groups and it was found that patients who underwent Akin osteotomy showed radiographically larger angle correction but less subjectivesatisfaction. Conclusion: Patients with moderate to severe hallux valgus who underwent distal chevron osteotomy showed not only functional butalso radiographically satisfactory results, and patients who underwent additional Akin osteotomy showed decreased subjective satisfaction. Therefore, if an incongruent first metatarsophalangeal joint is not observed, distal chevron osteotomy without Akin osteotomyseems preferable.
Abstract
Purpose: This study was conducted among patients with moderate to severe hallux valgus who underwent distal chevron osteotomyand groups of patients with or without Akin osteotomy were compared for evaluation of the relationship between their radiological andclinical outcomes. Materials and Methods: From January 2009 to January 2012, among patients with moderate to severe hallux valgus who underwentdistal chevron osteotomy at our institution, 28 cases with additional Akin osteotomy and 35 cases without Akin osteotomy available tofollow up of more than one year were included in this study. For radiologic evaluation, hallux valgus angle, 1, 2 intermetatarsal angle,and hallux interphalangeal angle were measured before and after surgery. For clinical assessment, visual analogue scale score, AmericanOrthopaedic Foot and Ankle Society score, subjective satisfaction of the patients, and passive range of motion of the first metatarsophalangealjoints were evaluated. Results: At the final follow up, correction of valgus hallux angle and 1, 2 intermetatarsal angle was obtained from radiation results ofboth groups and it was found that patients who underwent Akin osteotomy showed radiographically larger angle correction but less subjectivesatisfaction. Conclusion: Patients with moderate to severe hallux valgus who underwent distal chevron osteotomy showed not only functional butalso radiographically satisfactory results, and patients who underwent additional Akin osteotomy showed decreased subjective satisfaction. Therefore, if an incongruent first metatarsophalangeal joint is not observed, distal chevron osteotomy without Akin osteotomyseems preferable.
참고문헌 (18)
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