Artroplastia de Keller-Brandes versus artroplastia con hemiimplante para el tratamiento quirúrgico del hallux rigidus: análisis comparativo a medio plazo

Luis Lucinio Durán Alarcón , Gregorio Durán Arroyo , Pedro Antonio Dávila Muñoz
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Abstract

Introduction

There is no clear consensus regarding the best surgical treatment options in patients with hallux rigidus. The present study compares the effectiveness of 2 commonly used techniques in advanced cases of hallux rigidus: Keller artrhoplasty and hemi-implant artrhoplasty.

Patients and methods

All cases of hallux rigidus that underwent surgical treatment with either Keller or hemiimplant artrhoplasties during the year 2004 were analyzed. AOFAS scale and several angles in A/P x-rays were used for comparison at the preoperative moment and at 6 months, 1 year, 3 years and 5 years postoperatively.

Results

A total of 54 feet were included in the study (27 in each group of treatment). No differences were observed between groups in the AOFAS scale in all the postoperative moments analyzed. Significant differences were observed in the AOFAS score and in the complications of the techniques in each separate group by age factor.

Discussion

The results of the techniques of podiatric surgery of Keller and hemi-implant arthroplasty seems to be dependent on the age of the patient and progress time. Keller artrhoplasty have offered better results in patients older that 55, independently of the sex, but transfer metatarsalgia at 3 and 5 years is a common postoperative finding. The hemi-implant procedure seems to be more beneficial in patients less that 55.

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凯勒-布兰德斯关节成形术与半植入关节成形术治疗僵硬关节的中期比较分析
关于拇僵直患者的最佳手术治疗方案尚无明确的共识。本研究比较了两种常用的技术在晚期拇僵直病例中的有效性:Keller关节成形术和半植入关节成形术。患者和方法分析2004年所有采用Keller或半种植体关节成形术治疗拇僵直的病例。术前、术后6个月、1年、3年、5年采用AOFAS评分和A/P x线多个角度进行比较。结果共纳入54只脚(每组27只)。各组术后各时刻的AOFAS评分均无差异。不同年龄组患者的AOFAS评分及术后并发症均有显著差异。讨论足部手术和半假体关节置换术的效果似乎取决于患者的年龄和进展时间。凯勒关节成形术对55岁以上的患者疗效更好,与性别无关,但术后3至5年转移性跖骨痛是常见的发现。半植入手术似乎对小于55岁的患者更有益。
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