Purpose

The purpose of this study is to analyze the short- and long-term results of severe hallux valgus (HV) treated with a L-Reverse osteotomy.

Methods

Patients treated with L-Reverse osteotomy for severe HV between the years 2006–2015 were included. Patients were evaluated preoperatively, at 3 months and 4 or more years postoperatively. Changes in the HV angle (HVA) and intermetatarsal angle (IMA) were measured. Clinical outcomes were assessed using the AOFAS score.

Results

28 patients were included. Pre-operative IMA changed from 18.1° (18–18.9°) to 7° (6.3–8.5°), and HVA from 38.5° (34.5–41.3°) to 10.0° (8.4–11.8°) at 3 month follow up (p < 0.005). Long term follow up was of 5.6 (4.9–6.4) years. IMA value was 7.5° (6.1°−8.1°) and HVA was 10.1° (6.7°−16.3°), with no statistical difference with initial correction (p = 0.14). Median AOFAS score was 92.7 (89–4–96.1).

Conclusion

L-Reverse osteotomy can achieve correction of HV severe deformities with good outcomes in long term follow up.

Level of evidence

III

中文翻译：

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使用第一跖骨远端截骨术矫正严重拇外翻的短期和长期结果

目的

本研究的目的是分析严重拇外翻 (HV) 用L 型反向截骨术治疗的短期和长期结果。

方法

纳入了 2006-2015 年间因严重 HV 而接受L 型反向截骨术治疗的患者。在术前、术后 3 个月和 4 年或更长时间对患者进行评估。测量 HV 角 (HVA) 和跖骨间角 (IMA) 的变化。使用 AOFAS 评分评估临床结果。

结果

包括 28 名患者。术前 IMA 从 18.1°（18–18.9°）变为 7°（6.3–8.5°），HVA 在 3 个月随访时从 38.5°（34.5–41.3°）变为 10.0°（8.4–11.8°）（ p < 0.005）。长期随访为 5.6 (4.9–6.4) 年。IMA 值为 7.5° (6.1°−8.1°)，HVA 为 10.1° (6.7°−16.3°)，与初始校正无统计学差异 (p = 0.14)。AOFAS 得分中位数为 92.7 (89–4–96.1)。

结论

L- Reverse截骨术可矫正HV严重畸形，长期随访效果良好。

证据等级

三