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Less in-toeing after femoral derotation osteotomy in adult patients with increased femoral version and posterior hip impingement compared to patients with femoral retroversion
Journal of Hip Preservation Surgery ( IF 1.4 ) Pub Date : 2022-04-11 , DOI: 10.1093/jhps/hnac001
Till D Lerch 1 , Adam Boschung 2 , Christiane Leibold 2 , Roger Kalla 3 , Hassen Kerkeni 3 , Heiner Baur 4 , Patric Eichelberger 4 , Klaus A Siebenrock 2 , Moritz Tannast 2 , Simon D Steppacher 2 , Emanuel F Liechti 2
Affiliation  

In-toeing of the foot was associated with high femoral version (FV), while Out-toeing was associated with femoral-retroversion. Therefore, we report on (i) foot-progression-angle (FPA), (ii) prevalence of In-toeing and Out-toeing, and (iii) clinical outcome of patients treated with femoral-derotation-osteotomy (FDO). We performed a retrospective analysis involving 20 patients (20 hips) treated with unilateral FDO (2017–18). Of them, 14 patients had increased FV, 6 patients had femoral-retroversion. Follow-up time was mean 1 ± 1 years. All patients had minimal 1-year follow-up and the mean age was 29 ± 8 years. Patients with increased FV (FV > 35°) presented with positive posterior-impingement-test and mean FV was 49 ± 11° (Murphy method). Six patients with femoral-retroversion (FV < 10°) had positive anterior impingement test and mean FV of 5 ± 4°. Instrumented gait analysis was performed preoperatively and at follow-up using the Gaitrite system to measure FPA and was compared to a control group of 18 healthy asymptomatic volunteers (36 feet, mean age 29 ± 6 years). (i) Mean FPA increased significantly (P = 0.006) from preoperative 1.3 ± 7° to 4.5 ± 6° at follow-up for patients with increased FV and was not significantly different compared to the control group (4.0 ± 4.5°). (ii) In-toeing decreased from preoperatively (five patients) to follow-up (two patients) for patients with increased FV. Out-toeing decreased from preoperatively (two patients) to follow-up (no patient) for patients with femoral-retroversion. (iii) Subjective-hip-value of all patients increased significantly (P < 0.001) from preoperative 21 to 78 points at follow-up. WOMAC was 12 ± 8 points at follow-up. Patients with increased FV that underwent FDO walked with less In-toeing. FDO has the potential to reduce In-toeing and Out-toeing and to improve subjective satisfaction at follow-up.

中文翻译:

与股骨后倾患者相比,股骨旋转增加和髋关节后部撞击的成年患者股骨去旋截骨术后的脚趾内缩更少

足趾内翻与股骨高位 (FV) 相关,而外趾外翻与股骨后倾相关。因此,我们报告了 (i) 足前伸角 (FPA)、(ii) 内趾和外趾的患病率,以及 (iii) 接受股骨-去旋-截骨术 (FDO) 治疗的患者的临床结果。我们对 20 名接受单侧 FDO (2017-18) 治疗的患者(20 髋)进行了回顾性分析。其中FV增加14例,股骨后倾6例。随访时间平均为 1 ± 1 年。所有患者的随访时间最短为 1 年,平均年龄为 29 ± 8 岁。FV 增加(FV > 35°)的患者后部撞击试验呈阳性,平均 FV 为 49 ± 11°(墨菲法)。6 例股骨后倾(FV < 10°) 前部撞击试验阳性,平均 FV 为 5 ± 4°。在术前和随访中使用 Gaitrite 系统进行仪器步态分析以测量 FPA,并与 18 名健康无症状志愿者(36 英尺,平均年龄 29 ± 6 岁)的对照组进行比较。(i) 对于 FV 增加的患者,平均 FPA 从术前的 1.3 ± 7° 显着增加 (P = 0.006) 至 4.5 ± 6°,与对照组 (4.0 ± 4.5°) 相比没有显着差异。(ii) 对于 FV 增加的患者,从术前 (5 名患者) 到随访 (2 名患者) 中趾减少。对于股骨后倾患者,从术前(两名患者)到随访(无患者),外趾减少。(iii) 所有患者的主观髋关节值显着增加 (P < 0. 001)从术前 21 分到随访时 78 分。WOMAC 为 12 ± 8 分。接受 FDO 的 FV 增加的患者以较少的脚趾行走。FDO 有可能减少 In-toeing 和 Out-toeing 并提高随访时的主观满意度。
更新日期:2022-04-11
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