Percutaneous distal bicortical proximal phalanx osteotomy for second toe deformities – A two-year prospective cohort study

IF 1.9 3区医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2024-12-01 DOI:10.1016/j.fas.2024.06.001

Paulo Carvalho , Holly Johnson , Gabriel Ferreira , João Santos , Miki Dalmau-Pastor

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Abstract

Purpose

The main purpose of our study was to evaluate satisfaction, recurrence, bone union and other complications after a minimum of two years follow-up in patients who had percutaneous claw and hammer (CHT) second toe correction utilizing a novel distal and bicortical proximal phalanx osteotomy (DBPPO).

Methods

A minimum two-year follow-up prospective cohort study was conducted on consecutive patients with symptomatic CHT deformities of the second toe corrected with percutaneous surgery. Primary outcomes included satisfaction, recurrence, bony union, and other complication rates specific to the second toe deformity correction. Secondary outcomes included Metatarsophalangeal-Interphalangeal AOFAS scale and Visual Analogue Scale (VAS).

Results

Between January and October 2020, 34 patients (43 feet) were clinically and radiologically evaluated pre and postoperatively at a mean of 26.6 months. Thirty-eight feet (88.4 %) were satisfied or very satisfied with their second toe deformity correction and 41 feet (95.3 %) would undergo surgery on this toe again. No deformity recurrence requiring revision was found. There were two complications (4.7 %): one toe (2.3 %) with persistent numbness and one (2.3 %) had a simple infection that resolved with oral antibiotics. All 43 s toe osteotomies demonstrated bony consolidation. Stiffness was reported in nine second toes (20.9 %), seven of them (77.8 %) having a rigid pre-operative deformity. Secondary outcomes demonstrated significant improvement in the mean ( ± standard deviation) AOFAS score which increased from 47.5 ± 17.9 preoperatively to 95.7 ± 7.7 postoperatively (p < .001). Mean VAS significantly improved from 4.9 ± 2.5 preoperatively to 0.3 ± 1.3 postoperatively (p < .001).

Conclusion

Percutaneous treatment of claw and hammer second toe deformities utilizing a DBPPO resulted in high levels of satisfaction with bony consolidation, no recurrence and low complication rates at two years follow-up.Level of evidence: Level II – Prospective cohort study

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经皮远端双皮质近节指骨截骨术治疗第二趾畸形 - 一项为期两年的前瞻性队列研究

目的本研究的主要目的是评估采用新型远端和双皮质近端指骨截骨术（DBPPO）经皮爪锤（CHT）第二趾矫正的患者在至少2年随访后的满意度、复发率、骨愈合和其他并发症。方法对经皮手术矫正的有症状的第二趾CHT畸形患者进行至少2年随访的前瞻性队列研究。主要结果包括满意度、复发率、骨愈合和其他第二趾畸形矫正的并发症发生率。次要指标包括跖趾-指间AOFAS评分和视觉模拟评分（VAS）。结果2020年1月至10月期间，34例患者（43英尺）在术前和术后平均26.6个月进行了临床和放射学评估。38只脚（88.4%）满意或非常满意他们的第二脚趾畸形矫正，41只脚（95.3%）将再次接受该脚趾手术。未发现需要翻修的畸形复发。有两个并发症（4.7%）：一个脚趾（2.3%）持续麻木，一个（2.3%）有一个简单的感染，口服抗生素解决。所有43例脚趾截骨均显示骨实变。9个第二趾僵硬（20.9%），其中7个（77.8%）有僵硬的术前畸形。次要结果显示平均（±标准差）AOFAS评分显著改善，从术前的47.5±17.9增加到术后的95.7±7.7 (p <；措施)。平均VAS由术前4.9±2.5显著改善至术后0.3±1.3 (p <；措施)。结论采用DBPPO经皮治疗爪锤型第二趾畸形，术后2年随访无复发，并发症发生率低，骨巩固满意度高。证据等级：II级——前瞻性队列研究

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来源期刊

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.