矫形器对拇指内收外翻放射学测量的影响:系统回顾

IF 0.5 4区 医学 Q4 ORTHOPEDICS Journal of the American Podiatric Medical Association Pub Date : 2024-07-01 DOI:10.7547/23-171
Patrick A DeHeer, Niral A Patel, William Wolfe, Bethany Badell, Mallory Kirkland, Blake Wallace
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引用次数: 0

摘要

背景:拇外翻(HAV)通常被称为拇囊炎,是一种常见的足部畸形,其病因是多因素的,包括遗传倾向、生物力学异常和鞋袜选择。拇外翻通常采用保守疗法,使用矫形器来减少畸形发展和减轻相关疼痛。然而,矫形器在改变 HAV 影像学测量结果方面的有效性仍存在争议。本系统综述旨在评估矫形器干预对放射学参数的影响:方法:对五个电子数据库(PubMed、Cochrane Library、CINAHL、Medline 和 EMBASE)进行了全面检索,检索期从开始到 2021 年 3 月。检索包括与 HAV 和矫形干预相关的术语。如果研究提供了治疗前后半外翻角 (HAA)、半外翻角 (HVA) 或跖间角 (IMA) 的影像学测量结果,并涉及矫形器的使用,则被纳入研究范围。最初共确定了 523 篇参考文献,其中有 5 项研究符合纳入审查的标准。数据提取的重点是研究特点、矫形器类型、放射学测量和随访时间:系统性综述发现,没有足够的高质量证据支持矫形器在延缓HAV畸形进展方面的有效性。在纳入的五项研究中,结果参差不齐:两项研究报告了使用矫形器后放射学测量结果的变化,但其中一项研究涉及的是脚趾垫片而非传统矫形器。其余研究发现矫形器对 HAA、HVA 或 IMA 没有明显影响。研究设计、研究人群和矫形器类型的异质性限制了得出可靠结论的能力:结论:目前的证据并不完全支持使用矫形器来改变 HAV 的放射学进展。所回顾的研究强调了结果的显著差异性,并表明尽管矫形器可缓解症状,但其在畸形矫正中的作用仍不明确。矫形器是否以及在多大程度上影响了常见的 HAV 畸形放射学测量,还需要进一步的研究和调查来证明。
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Orthoses Effect on Radiographic Measurements of Hallux Abducto Valgus: A Systematic Review.

Background: Hallux abducto valgus (HAV), commonly referred to as a bunion, is a prevalent foot deformity with multifactorial etiology, including genetic predisposition, biomechanical abnormalities, and footwear choices. HAV is often managed conservatively with orthotic devices aimed at reducing deformity progression and alleviating associated pain. However, the effectiveness of orthotics in altering radiographic measurements of HAV remains debated. This systematic review aims to evaluate the impact of orthotic interventions on radiographic parameters.

Methods: A comprehensive search of five electronic databases-PubMed, Cochrane Library, CINAHL, Medline, and EMBASE-was conducted, covering the period from inception to March 2021. The search included terms related to HAV and orthotic interventions. Studies were included if they provided pre- and post-treatment radiographic measurements of halux abductus angle (HAA), hallux valgus angle (HVA), or intermetatarsal angle (IMA) and involved the use of orthotics. A total of 523 references were initially identified, with five studies meeting the inclusion criteria for review. Data extraction focused on study characteristics, orthotic type, radiographic measurements, and follow-up duration.

Results: The systematic review found insufficient high-quality evidence to support the effectiveness of orthotics in slowing the progression of HAV deformity. Of the five studies included, results were mixed: two studies reported changes in radiographic measurements following orthotic use, though one of these involved toe spacers rather than traditional orthotics. The remaining studies found no significant impact of orthotics on HAA, HVA, or IMA. The heterogeneity in study design, population, and orthotic types limited the ability to draw robust conclusions.

Conclusions: Current evidence does not conclusively support the use of orthotics for altering the radiographic progression of HAV. The reviewed studies highlight significant variability in outcomes and suggest that while orthotics may provide symptomatic relief, their role in deformity correction remains unclear. Whether and to what extent orthotics affect common radiographic measures of HAV deformity should be proven with further studies and investigation.

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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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