When Do Clinical and Radiographic Results Stabilize after Proximal Chevron Osteotomy in Hallux Valgus? / 대한족부족관절학회지

PURPOSE: The purpose of this study is to evaluate the sequential changes of clinical and radiographic results after proximal chevron osteotomy in patients with moderate to severe hallux valgus. MATERIALS AND METHODS: Between January 2008 and December 2009, 93 patients (117 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic moderate to severe hallux valgus deformity. The mean age of patients was 51 years (range, 19 to 71) and the mean duration of follow-up was 27.5 months (range, 24 to 35). Clinical results were evaluated using visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) score preoperatively, at 3, 6, and 12 months after surgery, and at the last follow-up. Radiographic parameters including hallux valgus angle, intermetatarsal angle, and sesamoid position were evaluated preoperatively, immediately postoperatively, at 6 weeks, at 3, 6, and 12 months after surgery, and at the last follow-up. RESULTS: VAS and AOFAS score showed significant improvement until 12 months after surgery. Hallux valgus angle and sesamoid position stabilized at 12 months after surgery and intermetatarsal angle stabilized at 6 months after surgery. CONCLUSION: Clinical and radiographic results were stabilized beyond 12 months after proximal chevron osteotomy in patients with moderate to severe hallux valgus.

Radiographic Results of Minimally Invasive (MIS) Lumbar Interbody Fusion (LIF) Compared with Conventional Lumbar Interbody Fusion

OBJECTIVE: To evaluate the radiographic results of minimally invasive (MIS) anterior lumbar interbody fusion (ALIF) and transforaminal lumbar interbody fusion (TLIF). METHODS: Twelve and nineteen patients who underwent MIS-ALIF, MIS-TLIF, respectively, from 2006 to 2008 were analyzed with a minimum 24-months' follow-up. Additionally, 18 patients treated with single level open TLIF surgery in 2007 were evaluated as a comparative group. X-rays and CT images were evaluated preoperatively, postoperatively, and at the final follow-up. Fusion and subsidence rates were determined, and radiographic parameters, including lumbar lordosis angle (LLA), fused segment angle (FSA), sacral slope angle (SSA), disc height (DH), and foraminal height (FH), were analyzed. These parameters were also compared between the open and MIS-TLIF groups. RESULTS: In the MIS interbody fusion group, statistically significant increases were observed in LLA, FSA, and DH and FH between preoperative and final values. The changes in LLA, FSA, and DH were significantly increased in the MIS-ALIF group compared with the MIS-TLIF group, but SSA and FH were not significantly different. No significant differences were seen between open and MIS-TLIF except for DH. The interbody subsidence and fusion rates of the MIS groups were 12.0+/-4% and 96%, respectively. CONCLUSION: Radiographic results of MIS interbody fusion surgery are as favorable as those with conventional surgery regarding fusion, restoration of disc height, foraminal height, and lumbar lordosis. MIS-ALIF is more effective than MIS-TLIF for intervertebral disc height restoration and lumbar lordosis.