PO 18217 - Radiographic evaluation of results of percutaneous surgery of Hallux Valgus

Jorge Eduardo de Schoucair Jambeiro, Antero Tavare Cordeiro Neto, Fernando Delmonte Moreira, J. A. Oliveira, Marcela Arimatea Cabral
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Abstract

Introduction: There is no consensus regarding the best surgical treatment for Hallux Valgus (HV). The use of percutaneous procedures for HV has been increasingly explored. The present study aims to evaluate and compare the radiographic results of percutaneous surgeries for HV treatment performed at our institution. Methods: A retrospective study was performed on radiographs and medical records of patients undergoing percutaneous surgery for HV treatment from August 2017 to August 2018. Using pre and postoperative radiographs, the Hallux valgus angle (HVA), intermetatarsal angle (IMA), and bone sesamoid deviation measurement and classification were performed according to the AOFAS criteria for angular measurements. Results: We evaluated the radiographs of 19 patients, representing a total of 25 feet, with a minimum segment time of four months, 84.2% females, and a mean age of 58 years. In 13 feet, there was an association of the Chevron and Akin techniques and in 12 of the Reverdin-Isham and Akin techniques. On average, the preoperative IMA was 13.4º, and in the postoperative period, 7.2º HVA had a mean of 26.3º in the preoperative period and in the postoperative period an average value of 11,2º. We observed improvement of the dislocation of the sesamoids in all cases by postoperative radiography. We did not find any serious complications. Discussion: There was a decrease in the postoperative measurements in all evaluated cases, with a mean of 15º in the HVA and 6,2º in the IMA. Chevron osteotomy associated with AKIN obtained a higher degree of correction of the IMA as predicted. The HVA using both techniques provided good correction without significant differences, which could be explained by the association of the Akin osteotomy in the two evaluated techniques.  Conclusion: Percutaneous surgeries with Chevron plus Akin and Riverdin-Isham plus Akin techniques performed at our institution proved to be efficient for HV correction, with a reduction of postoperative HVA and IMA.
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经皮拇外翻手术的影像学评价
关于拇外翻(HV)的最佳手术治疗尚无共识。使用经皮手术治疗艾滋病毒已越来越多的探索。本研究旨在评估和比较经皮手术治疗HV的影像学结果。方法:回顾性分析2017年8月至2018年8月接受经皮手术治疗的HV患者的x线片和病历。利用术前和术后x线片,根据AOFAS角度测量标准测量拇外翻角(HVA)、跖间角(IMA)和骨籽骨偏差测量和分类。结果:我们评估了19例患者的x线片,共25英尺,最小节段时间为4个月,84.2%为女性,平均年龄为58岁。在13英尺中,有雪佛龙和阿金技术的联系,在12英尺中有Reverdin-Isham和阿金技术的联系。术前IMA平均值为13.4º,术后HVA 7.2º,术前平均值26.3º,术后平均值11.2º。我们通过术后x线摄影观察到所有病例的籽状体脱位均有改善。我们没有发现任何严重的并发症。讨论:所有评估病例的术后测量值均有所下降,HVA平均为15º,IMA平均为6.2º。与AKIN相关的Chevron截骨术如预期的那样获得了更高程度的IMA矫正。使用这两种技术的HVA提供了良好的矫正,没有显著差异,这可以解释为两种评估技术中Akin截骨术的关联。结论:经皮手术采用Chevron + Akin和Riverdin-Isham + Akin技术在我们的机构被证明是有效的HV矫正,减少术后HVA和IMA。
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