| Objective: According to the pathological changes of palatine valgus deformity,the orthopedics team led by the director of the First Hospital of Tianjin,Dong Henggang,introduced the theory of liability malformation,and explored the new pathological classification,palate valgus index,and surgical classification based on the theory of liability malformation And the feasibility of the clinical application of surgical options in iliac valgus orthopedic surgery,the development of personalized treatment plans to guide the standard clinical treatment of valgus.Content and Methods: The first metatarsal varus caused three metamorphic pathological changes,including dislocation of the metatarsal head(dislocation of the metatarsal seed and metatarsophalangeal dislocation),an increase in the DMAA of the articular surface of the distal metatarsal head of the metatarsal head,and pronation of the metatarsal head,in which lead to the occurrence of valgus deformity.Hallux valgus surgery to develop new classification and surgical options responsibilities based on three kinds of deformities.The orthopedic team led by Director Dong Henggang of Tianjin First Hospital selected 182 patients with valgus treated with new surgical classification,11 males(14 feet)and 171 females(196 feet)),The age of surgery was 26 to 60 years,with an average of(42.1 ± 6.6)years,and the follow-up was 4 years.The radiographic parameters of the foot X-ray films were measured before surgery,1 year after surgery,and 4 years after surgery.The hallux valgus angle(HVA)and the distal metatarsal articular angle of the first metatarsal bone of the patella were compared(DMAA),intermetatarsal angle(IMA1-2),toe pronation angle(TPA)and tibial sesamoid position(TSP).The American Orthopedic Foot and Ankle Society(AOFAS)forefoot scoring system was used to evaluate the improvement of forefoot surgery function,and the Visual Analogue Score(VAS)system was used to evaluate the improvement of surgical pain.Toe scoring system was used to investigate postoperative satisfaction.Result: One year after operation,HVA decreased by 12.5 ± 4.1(P = 0.039),IMA1-2 decreased by 7.0 ± 1.8(P = 0.012),DMAA decreased by 11.6 ± 9.3(P = 0.022),and TPA decreased by 14.1 ± 2.9(P = 0.021),TSP improved 2.2 ± 0.7(P = 0.011),and the improvement of each index was statistically significant(P <0.05).Analysis of variance: There was no significant difference in HVA reduction between 4 years and 1 year after surgery(P = 0.582),no significant difference in IMA1-2 reduction(P = 0.342),and no significant difference in DMAA reduction.Significance(P = 0.274),no significant difference in TPA reduction(P = 0.233),and no improvement in TSP at tibial sesamoid position(P = 0.173).The Chi-square test of the American Foot and Ankle Surgery Association’s AOFAS forefoot score and visual analog score increased significantly after surgery compared with preoperative(AOFAS P = 0.011,VAS P = 0.002).Glynn comprehensive clinical evaluation,the excellent rate of excellent 187 feet 1 year after surgery is 89.1%(187/210),the excellent rate of excellent 190 feet 4 years after surgery is 90.47%(190/210);Glynn metatarsophagus scoring system 1 year after surgery The excellent rate of excellent 199 feet was 94.7%(199/210),and the excellent rate of excellent 200 feet 4 years after operation was 95.23%(200/210).Conclusion: It is the responsibility of abnormal development of new theories of the pathological type,hallux valgus indexing,classification and surgical options surgical clinically feasible,it may provide criteria for selecting programs for hallux valgus and individualized treatment plan after surgery The valgus deformity is significantly corrected,which can achieve good short-term and mid-term clinical effects and high patient satisfaction. |
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