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.