Modified Bösch Osteotomy Combined With a Percutaneous Adductor Tendon Release for the Treatment of Hallux Valgus Deformity: Learning Curve.

IF 1.8 Q2 ORTHOPEDICS Foot and Ankle Specialist Pub Date : 2024-08-01 Epub Date: 2022-03-03 DOI:10.1177/19386400221079198
Mauricio Esteban Ghioldi, Lucas Nicolás Chemes, Eric Daniel Dealbera, Mariano De Prado, Jorge Javier Del Vecchio
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Abstract

Purpose: The expression "learning curve" indicates the relation between the time needed to learn a new technique and the technique-related outcome. Percutaneous surgery (also called "minimally invasive surgery") has experienced sustained and respectable growth, especially in forefoot deformities. The main purpose was to assess the number of feet necessary to become skilled in a specific minimally invasive surgery (MIS) procedure.

Methods: From January 2015 to June 2018, 46 consecutive patients were evaluated and included in the study. Patients were divided into 2 groups according to the surgery period: first 30 feet (Group 1), and subsequent 30 feet (Group 2) from the whole population evaluated. Age, body mass index, and operative time were evaluated. Hallux valgus angle and the 1 to 2 intermetatarsal angle were also measured. Patients were assessed according to the American Orthopedic Foot and Ankle Society (AOFAS) forefoot scale, the Foot and Ankle Ability Measure activities of daily living (FAAM ADL) subscale and the visual analog scale (VAS).

Results: The comparison of the 2 groups showed statistically significant differences in hallux valgus angle (HVA) but not in intermetatarsal angle (IMA). The mean improvement between pre- and postoperative FAAM ADL, VAS, and AOFAS score in Group 1 were 12.83, 3.93, and 24.77 points, respectively. In Group 2, the mean improvement between pre- and postoperative FAAM ADL, VAS, and AOFAS scores were 15.19, 4.3, and 24.5 points, respectively. The differences between groups in FAAM ADL score was statistically significant (P = 0.0364). Group 1 showed a global complication rate of 16.67% (n = 5) while group 2 showed 3,3% (n = 1).

Conclusion: After the first 30 cases, radiographic, clinical, and functional outcomes substantially improved, and the level of the perioperative complications decreased. The results suggest that the learning curve plateau for performing a percutaneous subcapital osteotomy can be reached after 30 surgeries.

Levels of evidence: Level III.

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改良Bösch截骨术联合经皮腱加肌腱松解术治疗Hallux Valgus畸形:学习曲线。
目的“学习曲线”表示学习一项新技术所需的时间与技术相关结果之间的关系。经皮手术(也称为“微创手术”)经历了持续而可观的发展,尤其是前掌畸形。主要目的是评估掌握特定微创手术(MIS)所需的足部数量。方法从2015年1月至2018年6月,对46名连续患者进行评估并纳入研究。根据手术时间将患者分为两组:第一组为30英尺(第1组),第二组为整个评估人群中的30英尺。评估年龄、体重指数和手术时间。还测量了Hallux外翻角和1至2跖骨间角。根据美国足踝矫形学会(AOFAS)前掌量表、足踝日常生活能力测量量表(FAAM ADL)和视觉模拟量表(VAS)对患者进行评估。第1组术前和术后FAAM ADL、VAS和AOFAS评分的平均改善分别为12.83、3.93和24.77分。在第2组中,术前和术后FAAM ADL、VAS和AOFAS评分的平均改善分别为15.19、4.3和24.5分。FAAM ADL评分组间差异具有统计学意义(P=0.0364)。第1组的总体并发症发生率为16.67%(n=5),第2组为3,3%(n=1)。结论前30例后,放射学、临床和功能结果显著改善,围手术期并发症水平降低。结果表明,30例手术后可达到经皮冠状动脉下截骨的学习曲线平台。证据水平III级。
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来源期刊
Foot and Ankle Specialist
Foot and Ankle Specialist Health Professions-Podiatry
CiteScore
3.10
自引率
0.00%
发文量
100
期刊最新文献
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