Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However,...Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.展开更多
Objective:To study the imaging parameters of Chevron combined with Akin and Scarf combined with Akin for the correction of hallux valgus in patients of different ages.Methods:Eighty patients(152 feet)with hallux valgu...Objective:To study the imaging parameters of Chevron combined with Akin and Scarf combined with Akin for the correction of hallux valgus in patients of different ages.Methods:Eighty patients(152 feet)with hallux valgus who underwent Chevron combined with Akin and Scarf combined with Akin in our hospital were randomly selected.The patients were divided into young and middle-aged groups.Measure the hallux valgus angles(HVA),distal metatarsal articular angle(DMAA)and intermetatarsal angles(IMA)with professional X-ray measurement software and then reseach the effect of two the operation methods.Results:Young group:Chevron combined with Akin and Scarf combined with Akin significantly improved HVA and IMA,the difference had statistical significance(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).The improvement effect of the two groups on DMAA in young patients was not significant,and the difference had no statistical significance(P>0.05);Middle-aged group:Chevron combined with Akin and Scarf combined with Akin also significantly improved HVA and IMA(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).Chevron combined with Akin significantly improved DMAA in middle-aged and elderly patients,and the difference had statistical significance(P<0.05).Scarf combined with Akin did not significantly improve DMAA in middle-aged and elderly patients,and the difference had no statistical significance(P<0.05).Conclusion:Both Chevron combined with Akin and Scarf combined with Akin are effective and widely used.Chevron combined with Akin was able to improve DMAA in middle-aged and elderly patients.Therefore,Chevron combined with Akin is recommended for middle-aged and elderly patients with hallux valgus.展开更多
Background:There are no unified theories as to the anatomical changes that occur with hallux valgus,we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese ...Background:There are no unified theories as to the anatomical changes that occur with hallux valgus,we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese adults.Methods:We reviewed 141 patients with hallux valgus (206 feet; 15 males,126 females; mean age,58.5 years).These patients attended Peking University People's Hospital from April 2008 to March 2014.All feet had intact radiological data,obtained using the Centricity RIS/PACS system.We measured hallux valgus angle (HVA),1-2 intermetatarsal angle (IMA),proximal articular set angle (PASA),distal articular set angle,hallux interphalangeal angle,metatarsocuneiform angle,size of the medial eminence of the distal first metatarsal,tibial sesamoid position,and joint congruity of the first metatarsophalangeal joint (MTPJ).Results:We found positive correlations between the HVA and IMA (r =0.279,P 〈 0.01) and HVA and PASA (r =0.358,P 〈 0.01),but not for IMA and PASA (P 〉 0.05).Feet were divided into three groups based on HVA severity.IMA (P 〈 0.05) and PASA (P 〈 0.05) in the mild group were significantly lower than that in the moderate and severe groups,with no significant difference determined for IMA or PASA between the moderate and severe groups (P 〉 0.05).Feet were then grouped based on the shape of the first metatarsal head.Using this grouping,HVA was significant higher in the rounded shape (19.92°) than in a flat shape (17.66°).The size of the medial eminence of the distal first metatarsal was positively correlated with HVA (r =0.185,P 〈 0.01).The medial eminence in the moderate and severe groups was significantly larger than that in the mild group; moderate and severe groups were not significantly different.Conclusions:PASA enlargement is an adaptive change during early hallux valgus formation,and decompensation leads to subdislocation in the first MTPJ.A rounded first metatarsal head would thus predispose a foot to hallux valgus.Furthermore,bone proliferation at the medial eminence may also lead to early hallux valgus development.展开更多
Background:Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty (TKA). We aimed to investigate the effect of femoral lateral bowing and rotatio...Background:Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty (TKA). We aimed to investigate the effect of femoral lateral bowing and rotation on the radiographic measurements of distal femoral condyle resection thickness (DRT) and the distal femoral resection valgus angle (FVA). Methods: We analyzed 246 three-dimensional femoral models generated from computed tomography images of 123 patients, acquiring projected contours in seven positions – 20° and 10° internal rotation; 0° rotation; 10°, 20°, 30°, and 40° external rotation – for each model. Medial and lateral condyle DRTs, femoral shaft lateral bowing angle (FBA), and distal FVA were determined for each position. Linear mixed effect model was used to determine the effect of degree of femur rotation on repeated measurements of DRT or FVA. Results: FBA significantly affected the FVA and DRT (Pearson's R = 0.767 and -0.408, respectively; P 〈 0.000). Samples were divided into three groups according to the FBA measured in neutral position: FBA 〈0°: DRT 3.75 ± 1.30 mm, FVA 4.53° ± 1.27°; FBA 〉0° but 〈3°: DRT 3.39 ± 1.31 mm, FVA 5.92° ± 1.31°; FBA 〉3°: DRT 2.22 ± 1.31 mm, FVA 7.37° ± 1.31°. From simulated 20° internal rotation to 40° external rotation in each femoral model, the average variation ranges of radiographically measured DRT, FVA, and FBA were 0.50 ± 0.28 mm, 2.93° ± 0.96°, and 10.33° ± 1.90°, respectively, with no significant differences among the FBA groups. The degree of femoral rotation significantly affected the FVA (F = 62.148, P 〈 0.000), whereas there was no effect on condyle resection thickness (F = 0.4705, P = 0.494). Conclusions: Axial femoral rotation has less effect on radiographic measurements of differences in the DRT than on those of the distal FVA.展开更多
文摘Background: Hallux valgus deformity is one of the most common chronic and progressive foot deformities. Surgical correction of the deformity plays a central role in the treatment of symptomatic hallux valgus. However, more than one hundred different surgical techniques have been described. Objective: To assess the radiological outcome of hallux valgus surgical correction using a scarf and akin osteotomies. Materials and methods: A cross-sectional hospital-based study was conducted on 25 adult patients (36 feet). Twenty-two females and two males with hallux valgus were treated with surgical correction using a scarf and akin osteotomies. All candidates were kept on regular postoperative, scheduled clinical follow-up programs for one year and assessed radiologically. Results: Twenty-five patients (36 feet) were included in this study. The hallux valgus angle significantly shifted to the normal range (less than 15°) after surgery, and the inter-metatarsal angle also improved to the normal range (less than 9°). Conclusion: Using scarf and akin osteotomies in treating moderate and severe hallux valgus deformity provides the satisfactory radiological outcomes in form of decreasing hallux valgus angle and inter-metatarsal angle.
基金Planned project of Beijing municipal commission of science and technology(No.Z171100001017205)。
文摘Objective:To study the imaging parameters of Chevron combined with Akin and Scarf combined with Akin for the correction of hallux valgus in patients of different ages.Methods:Eighty patients(152 feet)with hallux valgus who underwent Chevron combined with Akin and Scarf combined with Akin in our hospital were randomly selected.The patients were divided into young and middle-aged groups.Measure the hallux valgus angles(HVA),distal metatarsal articular angle(DMAA)and intermetatarsal angles(IMA)with professional X-ray measurement software and then reseach the effect of two the operation methods.Results:Young group:Chevron combined with Akin and Scarf combined with Akin significantly improved HVA and IMA,the difference had statistical significance(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).The improvement effect of the two groups on DMAA in young patients was not significant,and the difference had no statistical significance(P>0.05);Middle-aged group:Chevron combined with Akin and Scarf combined with Akin also significantly improved HVA and IMA(P<0.05),but the improvement effect of the two groups was similar,and the difference had no statistical significance(P>0.05).Chevron combined with Akin significantly improved DMAA in middle-aged and elderly patients,and the difference had statistical significance(P<0.05).Scarf combined with Akin did not significantly improve DMAA in middle-aged and elderly patients,and the difference had no statistical significance(P<0.05).Conclusion:Both Chevron combined with Akin and Scarf combined with Akin are effective and widely used.Chevron combined with Akin was able to improve DMAA in middle-aged and elderly patients.Therefore,Chevron combined with Akin is recommended for middle-aged and elderly patients with hallux valgus.
文摘Background:There are no unified theories as to the anatomical changes that occur with hallux valgus,we investigated the radiological characteristics and anatomical risk factors for hallux valgus deformity in Chinese adults.Methods:We reviewed 141 patients with hallux valgus (206 feet; 15 males,126 females; mean age,58.5 years).These patients attended Peking University People's Hospital from April 2008 to March 2014.All feet had intact radiological data,obtained using the Centricity RIS/PACS system.We measured hallux valgus angle (HVA),1-2 intermetatarsal angle (IMA),proximal articular set angle (PASA),distal articular set angle,hallux interphalangeal angle,metatarsocuneiform angle,size of the medial eminence of the distal first metatarsal,tibial sesamoid position,and joint congruity of the first metatarsophalangeal joint (MTPJ).Results:We found positive correlations between the HVA and IMA (r =0.279,P 〈 0.01) and HVA and PASA (r =0.358,P 〈 0.01),but not for IMA and PASA (P 〉 0.05).Feet were divided into three groups based on HVA severity.IMA (P 〈 0.05) and PASA (P 〈 0.05) in the mild group were significantly lower than that in the moderate and severe groups,with no significant difference determined for IMA or PASA between the moderate and severe groups (P 〉 0.05).Feet were then grouped based on the shape of the first metatarsal head.Using this grouping,HVA was significant higher in the rounded shape (19.92°) than in a flat shape (17.66°).The size of the medial eminence of the distal first metatarsal was positively correlated with HVA (r =0.185,P 〈 0.01).The medial eminence in the moderate and severe groups was significantly larger than that in the mild group; moderate and severe groups were not significantly different.Conclusions:PASA enlargement is an adaptive change during early hallux valgus formation,and decompensation leads to subdislocation in the first MTPJ.A rounded first metatarsal head would thus predispose a foot to hallux valgus.Furthermore,bone proliferation at the medial eminence may also lead to early hallux valgus development.
文摘Background:Accurate evaluation of the plain radiography of lower limb is critical for preoperative planning of total knee arthroplasty (TKA). We aimed to investigate the effect of femoral lateral bowing and rotation on the radiographic measurements of distal femoral condyle resection thickness (DRT) and the distal femoral resection valgus angle (FVA). Methods: We analyzed 246 three-dimensional femoral models generated from computed tomography images of 123 patients, acquiring projected contours in seven positions – 20° and 10° internal rotation; 0° rotation; 10°, 20°, 30°, and 40° external rotation – for each model. Medial and lateral condyle DRTs, femoral shaft lateral bowing angle (FBA), and distal FVA were determined for each position. Linear mixed effect model was used to determine the effect of degree of femur rotation on repeated measurements of DRT or FVA. Results: FBA significantly affected the FVA and DRT (Pearson's R = 0.767 and -0.408, respectively; P 〈 0.000). Samples were divided into three groups according to the FBA measured in neutral position: FBA 〈0°: DRT 3.75 ± 1.30 mm, FVA 4.53° ± 1.27°; FBA 〉0° but 〈3°: DRT 3.39 ± 1.31 mm, FVA 5.92° ± 1.31°; FBA 〉3°: DRT 2.22 ± 1.31 mm, FVA 7.37° ± 1.31°. From simulated 20° internal rotation to 40° external rotation in each femoral model, the average variation ranges of radiographically measured DRT, FVA, and FBA were 0.50 ± 0.28 mm, 2.93° ± 0.96°, and 10.33° ± 1.90°, respectively, with no significant differences among the FBA groups. The degree of femoral rotation significantly affected the FVA (F = 62.148, P 〈 0.000), whereas there was no effect on condyle resection thickness (F = 0.4705, P = 0.494). Conclusions: Axial femoral rotation has less effect on radiographic measurements of differences in the DRT than on those of the distal FVA.