Effect of modified minimally invasive surgery of integrated traditional Chinese and western medicine combined with Akin osteotomy in treatment of patients with moderate to severe hallux valgus

YANG Yanjun; BAI Zixing; CAO Xuhan; SUN Chengyi; CHEN Si; ZHAO Haocheng; WEN Jianmin; SUN Weidong

doi:10.7619/jcmp.20214852

Journal of Clinical Medicine in Practice > 2022 > 26(17): 81-86. > DOI: 10.7619/jcmp.20214852

YANG Yanjun, BAI Zixing, CAO Xuhan, SUN Chengyi, CHEN Si, ZHAO Haocheng, WEN Jianmin, SUN Weidong. Effect of modified minimally invasive surgery of integrated traditional Chinese and western medicine combined with Akin osteotomy in treatment of patients with moderate to severe hallux valgus[J]. Journal of Clinical Medicine in Practice, 2022, 26(17): 81-86. DOI: 10.7619/jcmp.20214852

Citation:

PDF (2371 KB)

Effect of modified minimally invasive surgery of integrated traditional Chinese and western medicine combined with Akin osteotomy in treatment of patients with moderate to severe hallux valgus

1.
the Second Department of Osteoarthrosis, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, 100102
2.
Graduate School of Beijing University of Chinese Medicine, Beijing, 100029

More Information

Received Date: December 07, 2021
Available Online: August 31, 2022

Graphical Abstract

Abstract

Abstract

Objective
To investigate the clinical efficacy of modified minimally invasive surgery of integrated traditional Chinese and western medicine combined with Akin osteotomy in the treatment of patients with moderate to severe hallux valgus.
Methods
Sixty patients (114 feet) with moderate to severe hallux valgus were selected and divided into observation group and control group according to different surgical methods, with 30 cases in each group. The observation group was treated with modified minimally invasive surgery of integrated traditional Chinese and western medicine and Akin osteotomy, while the control group was treated with simple minimally invasive surgery of integrated traditional Chinese and western medicine. The hallux valgus angle (HVA), the intermetatarsal angle (IMA) between the first and second metatarsal bones, the distal articular set angle (DASA) and the score of the American Orthopedic Foot and Ankle Society (AOFAS) were compared between the two groups before operation, 6 weeks after operation and at the last follow-up.
Results
The patients in both group finished operations successfully, the postoperative healing was good, and no complications such as nonunion or delayed union of fracture, permanent injury of medial cutaneous nerve and necrosis of metatarsal head were observed. The HVA in the control group and the observation group decreased from (39.14±6.62)°, (40.20±7.15)° before operation to (9.45±3.70)°, (5.89±1.70)° at 6 weeks after operation and (14.94±4.63)°, (8.54±2.14)° at the last follow-up, and there were significant differences between two groups (P < 0.01). The IMA of the control group and the observation group decreased from (13.74±2.83)°, (13.66±2.52) °before operation to (10.35± 3.08)°, (10.11±2.57)° at 6 weeks after operation and (8.11±2.71)°, (7.62±2.85)° at the last follow-up, but there were no significant differences between two groups (P > 0.05). The DASA of the control group and the observation group decreased from (11.75±4.73)°, (11.58±4.20)° before operation to (9.87±2.53)°, (7.19±1.25)°at 6 weeks after operation and (7.88±1.35)°, (5.74 ± 1.07)°at the last follow-up, and there were significant differences between two groups (P < 0.01). The AOFAS scores of the control group and the observation group increased from (48.45±7.88), (49.61±8.77) before operation to (83.29±3.91), (88.74±4.41) at 6 weeks after operation and (88.67±3.87), (95.53±2.60) at the last follow-up, and there were significant differences between two groups (P < 0.01).
Conclusion
Modified minimally invasive surgery of traditional Chinese and western medicine and Akin osteotomy is effective in the treatment of patients with moderate and severe hallux valgus, the obvious postoperative complications are few, and the probability of recurrence and postoperative metastatic metatarsal pain is low.

FullText(HTML)

References (22)

References

[1]	AL-NAMMARI S S, CHRISTOFI T, CLARK C. Double first metatarsal and akin osteotomy for severe hallux Valgus[J]. Foot Ankle Int, 2015, 36(10): 1215-1222. doi: 10.1177/1071100715589173
[2]	OMAE H, OHSAWA T, HIO N, et al. Hallux Valgus deformity and postural sway: a cross-sectional study[J]. BMC Musculoskelet Disord, 2021, 22(1): 503. doi: 10.1186/s12891-021-04385-4
[3]	SMYTH N A, AIYER A A. Introduction: why are there so many different surgeries for hallux valgus[J]. Foot Ankle Clin, 2018, 23(2): 171-182. doi: 10.1016/j.fcl.2018.01.001
[4]	温建民, 佟云, 张帅, 等. 中医理论指导下的中西医结合微创术治疗拇外翻技术[J]. 北京中医药, 2018, 37(11): 1065-1068. https://www.cnki.com.cn/Article/CJFDTOTAL-BJZO201811020.htm
[5]	LAM P, LEE M, XING J, et al. Percutaneous surgery for mild to moderate hallux Valgus[J]. Foot Ankle Clin, 2016, 21(3): 459-477. doi: 10.1016/j.fcl.2016.04.001
[6]	GALLI S H, JOHNSON N, DAVIS W H, et al. Patient reported outcomes and recurrence following 127 primary Lapidus surgeries for hallux Valgus[J]. Foot Ankle Orthop, 2020, 5(4): 2473011420S0022.
[7]	BIZ C, FOSSER M, DALMAU-PASTOR M, et al. Functional and radiographic outcomes of hallux Valgus correction by mini-invasive surgery with Reverdin-Isham and Akin percutaneous osteotomies: a longitudinal prospective study with a 48-month follow-up[J]. J Orthop Surg Res, 2016, 11(1): 157. doi: 10.1186/s13018-016-0491-x
[8]	JEYASEELAN L, MALAGELADA F. Minimally invasive hallux Valgus surgery-A systematic review and assessment of state of the art[J]. Foot Ankle Clin, 2020, 25(3): 345-359. doi: 10.1016/j.fcl.2020.05.001
[9]	LIN Y C, CHENG Y M, CHANG J K, et al. Minimally invasive distal metatarsal osteotomy for mild-to-moderate hallux Valgus deformity[J]. Kaohsiung J Med Sci, 2009, 25(8): 431-437. doi: 10.1016/S1607-551X(09)70538-8
[10]	高国庆, 董颖, 温建民, 等. 中西医结合微创术截骨治疗重度拇外翻疗效观察[J]. 中国中医基础医学杂志, 2016, 22(1): 132-134. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC201601052.htm
[11]	毕锴, 温建民, 董颖. 阴阳、筋骨理论在中西医结合微创术技术治疗拇外翻中的应用[J]. 中医杂志, 2015, 56(14): 1202-1204. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201514014.htm
[12]	常程, 乔治, 温冠楠, 等. 拇外翻术后行"裹帘法"外固定对截骨端稳定性的影响[J]. 中华中医药杂志, 2017, 32(5): 2325-2328. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201705100.htm
[13]	谢飞, 常程, 温建民, 等. 拇外翻足有限元模型建立及"裹帘"外固定下的生物力学分析[J]. 中华中医药杂志, 2020, 35(3): 1559-1563. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202003136.htm
[14]	韩金昌, 温建民, 孙卫东. 中西医结合微创术治疗拇趾外翻临床应用进展[J]. 现代中西医结合杂志, 2014, 23(10): 1132-1134. https://www.cnki.com.cn/Article/CJFDTOTAL-XDJH201410050.htm
[15]	DOUTHETT S M, PLASKEY N K, FALLAT L M, et al. Retrospective analysis of the akin osteotomy[J]. J Foot Ankle Surg, 2018, 57(1): 38-43. doi: 10.1053/j.jfas.2017.06.026
[16]	TAY A Y W, GOH G S, KOO K, et al. Third-generation minimally invasive Chevron-akin osteotomy for hallux Valgus produces similar clinical and radiological outcomes as scarf-akin osteotomy at 2 years: a matched cohort study[J]. Foot Ankle Int, 2022, 43(3): 321-330. doi: 10.1177/10711007211049193
[17]	FERREIRA G F, BORGES V Q, MORAES L V M, et al. Percutaneous Chevron/Akin (PECA) versus open scarf/Akin (SA) osteotomy treatment for hallux Valgus: a systematic review and meta-analysis[J]. PLoS One, 2021, 16(2): e0242496. doi: 10.1371/journal.pone.0242496
[18]	LISZKA H, GADEK A. Percutaneous transosseous suture fixation of the akin osteotomy and minimally invasive Chevron for correction of hallux Valgus[J]. Foot Ankle Int, 2020, 41(9): 1079-1091. doi: 10.1177/1071100720935036
[19]	LISZKA H, GADEK A. Comparison of the type of fixation of akin osteotomy[J]. Foot Ankle Int, 2019, 40(4): 390-397. doi: 10.1177/1071100718816052
[20]	SINNETT T, FANG Y, NATTFOGEL E, et al. Suture fixation of an Akin osteotomy: a cost effective and clinically reliable technique[J]. Foot Ankle Surg, 2017, 23(1): 40-43. doi: 10.1016/j.fas.2016.02.002
[21]	温冠楠, 佟云, 张杰, 等. 微创截骨手法整复术治疗拇外翻[J]. 中国骨伤, 2021, 34(5): 467-471. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGU202105014.htm
[22]	GENG X, SHI J Q, CHEN W M, et al. Impact of first metatarsal shortening on forefoot loading pattern: a finite element model study[J]. BMC Musculoskelet Disord, 2019, 20(1): 625. doi: 10.1186/s12891-019-2973-6

[1]	LIU Ying, DU Likun, HU Lingdan, DU Zhiqiang, CUI Jing. Expression and significance of matrix metalloproteinases and toll-like receptor 9 in patients with acute leukemia[J]. Journal of Clinical Medicine in Practice, 2024, 28(15): 120-123, 129. DOI: 10.7619/jcmp.20240984
[2]	ZHANG Lanfang, CHEN Xu, KUAI Jun, QIN Lei, YANG Yan, CHANG Tingmin. Effect of tegafur, gimeracil and oteracil potassium combined with oxaliplatin on gastric motility-related hormones, matrix metalloproteinase-2 and matrix metalloproteinase-9 in elderly patients with gastric cancer[J]. Journal of Clinical Medicine in Practice, 2024, 28(12): 57-60, 65. DOI: 10.7619/jcmp.20241047
[3]	SUN Ling, LI Tantan, WU Xifeng, MEN Lijie, JIA Meiyan, LU Jun. Correlations of serum tissue inhibitor of metalloproteinases-1, matrix metalloproteinase-9 and vascular endothelial growth factor with degree of myelofibrosis in patients with myeloproliferative neoplasms[J]. Journal of Clinical Medicine in Practice, 2024, 28(11): 34-40. DOI: 10.7619/jcmp.20234037
[4]	SHAN Na, ZHAO Li, LIN Xiaodong. Predictive value of serum matrix metalloproteinase-9 and neurofilament light chain levels for cognitive impairment patients after first-onset ischemic stroke[J]. Journal of Clinical Medicine in Practice, 2023, 27(8): 67-70, 90. DOI: 10.7619/jcmp.20230606
[5]	WANG Fei, SHI Meihong. Relationships of BTB/POZ domain-containing protein 7 and matrix metalloproteinase-9 expression with autoantibodies in labial gland tissues of patients with primary Sjögren's syndrome[J]. Journal of Clinical Medicine in Practice, 2022, 26(21): 98-102. DOI: 10.7619/jcmp.20220899
[6]	YUAN Shanqi, ZHAO Hongmin, WANG Xiaoye, ZHANG Xi′an, HOU Pengfei, LIU Zhanhui. Application analysis of carotid ultrasound combined with detections of vascular endothelial growth factor, matrix metalloproteinase-9 and hypersensitive C-reactive protein in the stability of atherosclerotic plaque[J]. Journal of Clinical Medicine in Practice, 2019, 23(17): 27-29, 33. DOI: 10.7619/jcmp.201917008
[7]	ZHANG Yan, TU Jing, HUANG Hui. Study on the correlation between serum adiponectin and placental matrix metalloproteinase 9 in patients with gestational hypertension[J]. Journal of Clinical Medicine in Practice, 2017, (3): 96-98. DOI: 10.7619/jcmp.201703029
[8]	LU Jianjun, YI Liping, TUO Ya, QIAO Huizhen. Expression and clinical significance of matrix metalloproteinases-9 in tissues of endometrial carcinoma[J]. Journal of Clinical Medicine in Practice, 2014, (15): 63-65,69. DOI: 10.7619/jcmp.201415019
[9]	GAO Mingjun, QI Bo. Influence of irbesartan and amlodipine on carotid-femoral artery pulse wave velocity and serum matrix metalloproteinase-9 level in patients with primary hypertension[J]. Journal of Clinical Medicine in Practice, 2013, (23): 12-14,18. DOI: 10.7619/jcmp.201323004
[10]	ZHANG Yuhua, CAI Xiangzeng, GUO Minghe. Effects of Chuanxiongqin on serum high-sensitivity C-reactive protein, interleukin-6 and matrix metalloproteinases-9 in treating acute cerebral infarction[J]. Journal of Clinical Medicine in Practice, 2013, (17): 78-80. DOI: 10.7619/jcmp.201317026

Cited By

Cited by

Periodical cited type(3)

1.	王娟，郭潍宁，陆小莉，章馨，陶云，沈薛. 妊娠期胎动监测与胎动减少管理最佳证据总结. 全科护理. 2024(17): 3169-3175 .
2.	姚娟娟，黄秀霞，岳智慧，邓瑾微. 导乐联合哀伤护理在围产期丧失产妇护理中的应用效果. 中国社区医师. 2023(32): 142-144 .
3.	程彩霞. 单胎妊娠晚期胎死宫内的病因分析与预防策略. 实用妇科内分泌电子杂志. 2023(35): 47-49 .

Other cited types(0)

Get Citation

PDF

XML

Article views (227) PDF downloads (5) Cited by(3)

Turn off MathJax

Article Contents

Abstract

References

Effect of modified minimally invasive surgery of integrated traditional Chinese and western medicine combined with Akin osteotomy in treatment of patients with moderate to severe hallux valgus