The intermediate outcome of patients who underwent a modified Lapidus procedure for the treatment of hallux valgus secondary to a hypermobile first ray was evaluated with an outcome tool to determine if their pain and functional status were improved. We evaluated 31 feet in 26 patients who underwent a modified Lapidus procedure. All working patients (100%) returned to full-time work. Six patients were retired and one was unemployed prior to surgery. There was an average of eight months until sports or unlimited activities were performed, and an average 16 weeks until conventional shoes could be worn. All patients but one (96%) were satisfied with the surgery and knowing their results would have the surgery again. Postoperative pain relief satisfaction was totally satisfied in 19 patients, satisfied with reservations in six patients, and not satisfied in one patient. Postoperative appearance satisfaction was totally satisfied in 21 patients and satisfied with reservations in five patients. Postoperative joint motion was no noticeable stiffness in 22 patients, noticeable stiffness but not bothersome in three patients, and stiffness that impairs activity in one patient (two feet). In the radiographic measurements, there was an average improvement of 10 degrees in the hallux valgus angle, 10 degrees in the intermetatarsal angle, two degrees in the lateral metatarsal-floor angle and two grades in the sesamoid position. Complications experienced were five recurrent deformities, two metatarsalgias, and one deep vein thrombosis. One of the five recurrences became symptomatic and required a revision.
通过使用一个结果工具来评估经过改良的Lapidus手术治疗由于第一跖骨过度活动引起的拇外翻症患者的中间结果,以确定他们的疼痛和功能状态是否得到改善。我们评估了26名患者中的31只脚接受了改良的Lapidus手术。所有工作患者(100%)都恢复到了全职工作。术前有6名患者退休,1名失业。平均需要8个月才能进行运动或无限制活动,平均16周才能穿上传统鞋子。除一名患者外(96%),所有患者都对手术结果满意,并且知道他们的结果会再次接受手术。术后疼痛缓解满意度在19名患者中完全满意,在6名患者中满意但有保留,在一名患者中不满意。术后外观满意度在21名患者中完全满意,在5名患者中满意但有保留。术后关节活动范围在22名患者中没有明显的僵硬,3名患者中有明显的僵硬但不影响活动,1名患者(2只脚)有影响活动的僵硬。在放射学测量中,拇外翻角度平均改善了10度,跖骨间角度平均改善了10度,侧跖骨-地板角度平均改善了2度,而骶骨骨骼位置平均提高了2级。经历的并发症包括5例复发畸形,2例跖部疼痛和1例深静脉血栓形成。其中5个复发病例中的一个出现症状,需要进行修复手术。