Midterm outcomes of the modified Lapidus arthrodesis using the Phantom® Intramedullary Nail System for the treatment of hallux valgus

IF 1.9 3区 医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2024-05-31 DOI:10.1016/j.fas.2024.05.001
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Abstract

Background

Lapidus arthrodesis is one of the most commonly used techniques in the correction of moderate and severe hallux valgus. We analyzed the clinical and radiological outcomes after using the Phantom® Lapidus intramedullary nail to find an effective technique with low complications.

Methods

We retrospectively analyzed data of 52 patients who underwent a modified Lapidus arthrodesis with an intramedullary nail at our center from November 2019 to September 2022. The mean follow-up period was 27 (range, 18–34) months. Clinical results were evaluated using the visual analog scale (VAS), the European Foot and Ankle Society score (EFAS) and the American Orthopaedic Foot and Ankle Society score (AOFAS); three different radiological measures were analyzed.

Results

The mean AOFAS score increased from 44.8 to 82 points. The mean EFAS score increased from 11.2 to 20.1 points. The mean VAS score decreased by 4.7 points. The mean EFAS Sport score was increased from 9.2 (SD 4.6) to 12.6 (SD 5.4) points. The intermetatarsal angle decreased from 15° to 6.9° and the hallux valgus angle by a mean of 17.9°. The forefoot width reduced from 93.6 to 84.7 mm. All results were statistically significant (p < .001). One case of nonunion was recorded. No implant-related complications were observed.

Conclusions

This device was effective in correcting moderate to severe hallux valgus, with significant patient satisfaction. Its complication rate was not higher than that of other fixation devices. Correct compression of the arthrodesis, absence of extraosseous material, and multidirectional stability are important qualities of this implant for the correct treatment of this pathology.

Level of Evidence

Level IV, retrospective case series

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使用 Phantom® 髓内钉系统进行改良 Lapidus 关节固定术治疗足外翻的中期疗效。
背景:Lapidus关节置换术是矫正中度和重度拇指外翻最常用的技术之一。我们分析了使用 Phantom® Lapidus 髓内钉后的临床和放射学结果,以找到一种并发症少的有效技术:我们回顾性分析了2019年11月至2022年9月在本中心接受改良Lapidus髓内钉关节置换术的52名患者的数据。平均随访时间为 27 个月(18-34 个月)。临床结果采用视觉模拟量表(VAS)、欧洲足踝协会评分(EFAS)和美国骨科足踝协会评分(AOFAS)进行评估,并对三种不同的放射学指标进行了分析:结果:AOFAS 的平均得分从 44.8 分上升到 82 分。EFAS平均得分从11.2分上升到20.1分。VAS 平均得分降低了 4.7 分。平均 EFAS 运动得分从 9.2 分(标准差 4.6 分)增加到 12.6 分(标准差 5.4 分)。跖骨间角度从 15°减小到 6.9°,拇指外翻角度平均减小了 17.9°。前足宽度从 93.6 毫米减少到 84.7 毫米。所有结果均具有统计学意义(P 结论:该装置可有效矫正中度足外翻:该装置能有效矫正中度至重度的足外翻,患者满意度很高。其并发症发生率并不比其他固定装置高。关节固定的正确压迫、无骨外材料和多向稳定性是该假体正确治疗该病症的重要品质:证据级别:IV级,回顾性病例系列。
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来源期刊
Foot and Ankle Surgery
Foot and Ankle Surgery ORTHOPEDICS-
CiteScore
4.60
自引率
16.00%
发文量
202
期刊介绍: Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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