Percutaneous Chevron Osteotomy in Treating Hallux Valgus: Hong Kong Experience and Mid-Term Results: 經皮Chevron截骨術治療拇外翻：香港的經驗和中期結果

Background/PurposeMinimally invasive surgery (MIS) has become popular in every specialty. Different distal metatarsal osteotomy methods using minimally invasive percutaneous approach with or without fixation have been proposed to treat mild to moderate degrees of hallux valgus.MethodsFrom June 2010 to May 2012, we performed 23 percutaneous chevron osteotomies with screw fixation in 20 patients.ResultsAt 18 months postoperatively, the mean hallux valgus angle (HVA) was corrected from 31.68° to 14.39°, mean intermetatarsal angle (IMA) from 13.77° to 7.98° and mean American Orthopaedic Foot and Ankle Society (AOFAS) score from 59.26 to 88.35. There were four cases of medial plication stitch impingement and four cases with screw impingement but no other complications such as joint stiffness, avascular necrosis of metatarsal head, union complication, wound infection or deep vein thrombosis.ConclusionThe mid-term results are encouraging, indicating that this is an effective method in the treatment of mild to moderate hallux valgus with advantages of percutaneous technique. Further study with longer-term results and larger sample size is needed in order to compare with other percutaneous or open techniques.

中文摘要目的微創手術(‬minimally invasive surgery)‬在每一個專科都普及起來。不同的微創經皮遠端蹠骨截骨術(‬有或無內固定)‬，都被提出來治療輕度至中度的拇外翻。‬‬‬‬方法從2010年6月至2012年5月，我們在20個病人上完成了23個經 ‬皮chevron截骨術和螺釘內固定。‬結果在術後18個月的平均拇外翻角（HVA）從31.68 ‬矯正到14.39，平均蹠骨間角（IMA）從13.77 ‬至 ‬7.98 ‬，平均美國骨科足踝協會評分（AOFAS評分）從59.26到88.35。當中有4個病人出現內側折疊術縫線夾擠和4個病人出現螺釘夾擠，但無其他併發症(‬如關節僵硬，蹠骨頭缺血性壞死，愈合問題，傷口感染或深靜脈血栓形成)‬。‬‬‬‬‬‬結論中期結果是令人鼓舞的，表明這是一種有效的方法治療輕中度拇外翻並擁有經皮技術的優勢。需要有更長期和更大的樣本的研究，來與其他經皮或開放技術作比較。