무지외반증 치료에서 근위 중족골 절골술과 원위 갈매기형 절골술의 비교 (Comparison of Proximal Metatarsal Osteotomy and Distal Chevron Osteotomy for Correction of Hallux Valgus)

서지정보

· 발행기관 : 대한족부족관절학회
· 수록지 정보 : 대한족부족관절학회지 / 12권 / 1호 / 20 ~ 25페이지
· 저자명 : 조덕연, 이동훈, 이승용, 이인성

초록

Purpose: The purpose of this study is comparison of radiological and clinical outcomes between proximal metatarsal
osteotomy and distal chevron osteotomy for the correction of hallux valgus.
Materials and Methods: In this retrospective study, we included subjects who underwent the correction of hallux
valgus in our institution between March 2001 and August 2006, with a minimum follow-up of 12 months. The group
of proximal metatarsal osteotomy was 23 patients (34 feet); the group of distal chevron osteotomy was 20 patients (26 feet).
The group of proximal metatarsal osteotomy was composed of 26 severe cases (76.5%) and 8 moderate cases (23.5%);
the group of distal chevron osteotomy was composed of 13 severe cases (50.0%) and 13 moderate cases (50.0%).
Results: Compared to preoperative values, the hallux valgus angle, the first-second intermetatarsal angle and the
distance of first-fifth metatarsal head were significantly decreased in two groups (p<0.05). In each parameter, the hallux
valgus angle was decreased 66.3% (proximal metatarsal osteotomy) versus 49.6% (distal chevron osteotomy), which
were significant (p=0.037). The first-second intermetatarsal angle and the distance of first-fifth metatarsal head were
not significant. Mayo clinic forefoot scoring system (FFSS) score was significantly improved in two groups
(p<0.05). The ratio of improvement was not significant (p=0.762). In severe group, hallux valgus angle and the firstsecond
intermetatarsal angle was significantly decreased in proximal metatarsal osteotomy group compared to distal
chevron osteotomy group (p<0.05), but the difference of the distance of first-fifth metatarsal head and FFSS score was
not significant in both groups. In moderate group, the difference of all parameters was not significant in both groups.
Conclusion: Although both proximal metatarsal osteotomy and distal chevron osteotomy showed satisfactory result in
FFSS, proximal metatarsal osteotomy was more proper operative technique than distal chevron osteotomy in severe
group, because of superiority of correction in radiological parameters.

영어초록

Purpose: The purpose of this study is comparison of radiological and clinical outcomes between proximal metatarsal
osteotomy and distal chevron osteotomy for the correction of hallux valgus.
Materials and Methods: In this retrospective study, we included subjects who underwent the correction of hallux
valgus in our institution between March 2001 and August 2006, with a minimum follow-up of 12 months. The group
of proximal metatarsal osteotomy was 23 patients (34 feet); the group of distal chevron osteotomy was 20 patients (26 feet).
The group of proximal metatarsal osteotomy was composed of 26 severe cases (76.5%) and 8 moderate cases (23.5%);
the group of distal chevron osteotomy was composed of 13 severe cases (50.0%) and 13 moderate cases (50.0%).
Results: Compared to preoperative values, the hallux valgus angle, the first-second intermetatarsal angle and the
distance of first-fifth metatarsal head were significantly decreased in two groups (p<0.05). In each parameter, the hallux
valgus angle was decreased 66.3% (proximal metatarsal osteotomy) versus 49.6% (distal chevron osteotomy), which
were significant (p=0.037). The first-second intermetatarsal angle and the distance of first-fifth metatarsal head were
not significant. Mayo clinic forefoot scoring system (FFSS) score was significantly improved in two groups
(p<0.05). The ratio of improvement was not significant (p=0.762). In severe group, hallux valgus angle and the firstsecond
intermetatarsal angle was significantly decreased in proximal metatarsal osteotomy group compared to distal
chevron osteotomy group (p<0.05), but the difference of the distance of first-fifth metatarsal head and FFSS score was
not significant in both groups. In moderate group, the difference of all parameters was not significant in both groups.
Conclusion: Although both proximal metatarsal osteotomy and distal chevron osteotomy showed satisfactory result in
FFSS, proximal metatarsal osteotomy was more proper operative technique than distal chevron osteotomy in severe
group, because of superiority of correction in radiological parameters.

참고자료

· 없음