Percutaneous distal chevron osteotomy is associated with lower immediate postoperative pain and a greater range of motion than the open technique: A prospective randomized study.

Autor: Yoon H; Yonseinice Hospital, Seoul, Republic of Korea., Park KH; Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea., Jo J; Gangbukyonsei Hospital, Seoul, Republic of Korea., Lee M; Yonsei 100% Hospital, Incheon, Republic of Korea., Lee JW; Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea., Kim HJ; Department of Orthopaedic Surgery, Korea University Guro Hospital, Seoul, Republic of Korea., Shin GJ; Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-Si, Republic of Korea., Choi GW; Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-Si, Republic of Korea. manbalian@gmail.com.
Jazyk: angličtina
Zdroj: International orthopaedics [Int Orthop] 2024 Sep; Vol. 48 (9), pp. 2383-2394. Date of Electronic Publication: 2024 Jun 05.
DOI: 10.1007/s00264-024-06231-3
Abstrakt: Purpose: The results of past studies comparing percutaneous techniques with traditional open techniques for hallux valgus are controversial. Therefore, this study aimed to compare the radiologic and clinical outcomes of percutaneous and open distal chevron osteotomies.
Methods: Seventy-one patients with mild to severe hallux valgus deformity were randomized to undergo percutaneous distal chevron osteotomy (percutaneous group, n = 36) or open distal chevron osteotomy (open group, n = 35) between October 2019 and September 2020. Radiological and clinical outcomes were assessed preoperatively and postoperatively. Outcome measures included the foot and ankle outcome score, foot functional index, visual analogue scale (VAS) scores for pain, range of motion (ROM) of the first metatarsophalangeal (MTP) joint, hallux valgus angle, intermetatarsal angle, and first metatarsal shortening. Additionally, the first metatarsal declination angle was measured to evaluate sagittal malunion.
Results: The mean first metatarsal declination angle decreased significantly at 12 months postoperatively in both groups (p = 0.021 and p < 0.001 in the percutaneous and open groups, respectively), and the decrement was significantly greater in the open group (p = 0.033). The mean VAS score for pain on postoperative day one was 4.2 ± 1.9 and 5.3 ± 1.7 in the percutaneous and open groups, respectively (p = 0.019). The mean ROM of the first MTP joint did not change significantly after surgery, from 72.5 ± 7.5 preoperatively to 71.0 ± 9.5 at 12 months postoperatively in the percutaneous group (p = 0.215); however, it decreased significantly from 70.6 ± 7.3 preoperatively to 63.4 ± 10.4 at 12 months postoperatively in the open group (p < 0.001). There were no significant differences between the groups regarding other clinical outcomes.
Conclusion: The percutaneous group showed a lower immediate pain level at postoperative day 1 and better ROM of the first MTP joint at 12 months postoperatively.
(© 2024. The Author(s) under exclusive licence to SICOT aisbl.)
Databáze: MEDLINE
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