Percutaneous distal bicortical proximal phalanx osteotomy for second toe deformities - A two-year prospective cohort study.

Autor: Carvalho P; Hospital da Ordem Terceira Chiado, Lisbon, Portugal; Hospital da Luz, Orthopedics, Setúbal, Portugal. Electronic address: pscarvalholda@gmail.com., Johnson H; Hospital for Special Surgery, Orthopaedic Surgery, New York, USA. Electronic address: johnsonh@hss.edu., Ferreira G; Hospital do Servidor Publico Estadual de Sao Paulo, Orthopedics, São Paulo, Brazil. Electronic address: gabriel.ferraz38@yahoo.com.br., Santos J; Hospital do Espírito Santo de Évora EPE, Orthopedics, Évora, Portugal. Electronic address: joaorrdossantos1995@gmail.com., Dalmau-Pastor M; Hospital da Luz, Orthopedics, Setúbal, Portugal; Human Anatomy Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. Electronic address: mikeldalmau@ub.edu.
Jazyk: angličtina
Zdroj: Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons [Foot Ankle Surg] 2024 Dec; Vol. 30 (8), pp. 706-712. Date of Electronic Publication: 2024 Jun 13.
DOI: 10.1016/j.fas.2024.06.001
Abstrakt: Purpose: The main purpose of our study was to evaluate satisfaction, recurrence, bone union and other complications after a minimum of two years follow-up in patients who had percutaneous claw and hammer (CHT) second toe correction utilizing a novel distal and bicortical proximal phalanx osteotomy (DBPPO).
Methods: A minimum two-year follow-up prospective cohort study was conducted on consecutive patients with symptomatic CHT deformities of the second toe corrected with percutaneous surgery. Primary outcomes included satisfaction, recurrence, bony union, and other complication rates specific to the second toe deformity correction. Secondary outcomes included Metatarsophalangeal-Interphalangeal AOFAS scale and Visual Analogue Scale (VAS).
Results: Between January and October 2020, 34 patients (43 feet) were clinically and radiologically evaluated pre and postoperatively at a mean of 26.6 months. Thirty-eight feet (88.4 %) were satisfied or very satisfied with their second toe deformity correction and 41 feet (95.3 %) would undergo surgery on this toe again. No deformity recurrence requiring revision was found. There were two complications (4.7 %): one toe (2.3 %) with persistent numbness and one (2.3 %) had a simple infection that resolved with oral antibiotics. All 43 s toe osteotomies demonstrated bony consolidation. Stiffness was reported in nine second toes (20.9 %), seven of them (77.8 %) having a rigid pre-operative deformity. Secondary outcomes demonstrated significant improvement in the mean ( ± standard deviation) AOFAS score which increased from 47.5 ± 17.9 preoperatively to 95.7 ± 7.7 postoperatively (p < .001). Mean VAS significantly improved from 4.9 ± 2.5 preoperatively to 0.3 ± 1.3 postoperatively (p < .001).
Conclusion: Percutaneous treatment of claw and hammer second toe deformities utilizing a DBPPO resulted in high levels of satisfaction with bony consolidation, no recurrence and low complication rates at two years follow-up.
Level of Evidence: Level II - Prospective cohort study.
Competing Interests: Competing interests The authors have no relevant financial or non-financial interests to disclose.
(Copyright © 2024 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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