대한족부족관절학회지 (Journal of Korean Foot and Ankle Society)

  • 제19권2호
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  • Pages.51-57
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  • 2015
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  • 1738-3757(pISSN)
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  • 2288-8551(eISSN)
대한족부족관절학회 (Korean Foot & Ankle Society)
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중등도 이상의 무지 외반증에서 최소 절개를 이용한 원위 중족골 절골술의 결과

Results of Minimal Incision Distal Metatarsal Osteotomy for Moderate to Severe Hallux Valgus

  • Huh, Jung-Wook (Department of Orthopedic Surgery, Busan Medical Center) ;
  • Eun, Il-Soo (Department of Orthopedic Surgery, Busan Medical Center) ;
  • Ko, Young-Chul (Department of Orthopedic Surgery, Busan Medical Center) ;
  • Park, Man-Jun (Department of Orthopedic Surgery, Busan Medical Center) ;
  • Park, Sook-Hyun (Department of Orthopedic Surgery, Busan Medical Center)
  • 투고 : 2015.04.06
  • 심사 : 2015.05.27
  • 발행 : 2015.06.15
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초록

Purpose: Minimal incision distal metatarsal osteotomy (MIDMO) is known to be an effective surgical procedure for mild to moderate hallux valgus. However, the result of MIDMO on moderate to severe hallux valgus is controversial; therefore, we investigated the radiological and clinical results of MIDMO on moderate to severe hallux valgus. Materials and Methods: We reviewed 51 feet (48 patients) with moderate to severe hallux valgus. The mean age was 67.0 years and the mean follow-up period was 32.2 months. Radiological data of hallux valgus angle, first intermetatarsal angle, and distal metatarsal articular angle on plain radiographs were analyzed. Recurrence, union, lateral translation of distal fragment and angulation were also analyzed. The clinical data were obtained using American Orthopaedic Foot and Ankle Society (AOFAS) score of preoperation and last follow-up. Receiver operating characteristic (ROC) curve was used to determine a cut-off value. Results: The mean hallux valgus angle measured at preoperation was $37.7^{\circ}$ and $15.9^{\circ}$ at last follow-up. The mean first intermetatarsal angle of preoperation and last follow-up were $15.2^{\circ}$ and $8.3^{\circ}$. The mean distal metatarsal articular angle changed from $12.6^{\circ}$ at preoperation to $7.8^{\circ}$ at last follow-up. Preoperative hallux valgus angle (p=0.0051) and distal metatarsal articular angle (p=0.0078) were statistically significant factors affecting postoperative AOFAS score. Cut-off value of each was $37^{\circ}$ and 13o, respectively. Lateral translation of distal fragment in 5 recurrent cases was 23.0% compared to 45.3% of 46 non-recurrent cases. The result was statistically significant and the cut-off value was 38%. Conclusion: Sufficient lateral translation over 38% in MIDMO on moderate to severe hallux valgus patients with preoperative hallux valgus angle under $37^{\circ}$ and distal metatarsal articular angle under $13^{\circ}$ can lead to good clinical results without recurrence.

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참고문헌

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