Compare Adolescent Hallux Valgus Osteotomy Two Fixed Effects.

Objective: By comparing adolescents hallucis first metatarsal osteotomy in patients after valgus application, were applied with effect Kirschner plate fixed osteotomy of the two methods to find better methods that fixed effects.Methods:A retrospective study from January 2008 to July 2014 period, 39 cases were treated juvenile hallux valgus(72 feet), There are 23 cases(40 feet) were followed, The followed cases were divided into A group and B group by different internal fixation method, A group were fixed by Kirschner wire, B group were fixed by plate. A group of 12 cases of 20 feet, 3 cases of males and 9 females, mean age 17.0 years old(11 years old to 22 years old); group B 11 Example 20 feet, 2 males, 9 females, mean age 17.6 years old(1l years old to 24 years old). A group B were applied first metatarsal osteotomy for hallux valgus(depending on the disease to select different osteotomy site), A Kirschner wire fixation group, group B fixing plate. Each foot before and after surgery, weight-bearing foot were taken last follow-up lateral X-ray, measure HVA and 1 ~ 2IMA; functional assessment based AOFAS hallux metatarsophalangeal joint, interphalangeal joint score, and recorded concurrently disease occurrence. Comparison of preoperative and postoperative follow-up after the end of the room when the hallux valgus angle(HVA) and 1-2 metatarsal angle(IMA) and the AOFAS score more functional assessment of the patient, choose SPSS 19.0 statistical data, data were presented as mean ± standard deviation(c±s) to represent, were compared using t test, when P <0.05, the difference was statistically significant.Results:There are 23 cases(40 feet) were followed, including 5 males(8 feet) and 18 females(32 feet); mean age 17.3 ± 3.4 years(11 to 24 years old). The average follow-up of 15.6 months(12 to 20 months), no infection and nonunion occurs, there are two cases of 3 feet(7.5 percent) occurs when weight-bearing walking down the first metatarsophalangeal joint mild pain, 4 cases of 7 feet(17.5%) appears recurrence of hallux valgus foot. Group A: HVA decreased from preoperative average 35.1 ° ± 2.7 ° to 1 day after the average 16.5 ° ± 1.6 °(P <0.01), after an average annual 22.1 ° ± 3.0°(P <0.01); 1 ~ metatarsal angle between two IMA decreased from preoperative average 15.8 ° ± 2.5 ° to 1 day after an average 8.7 ° ± 0.7 °(P <0.01), after an average annual 10.7 ° ± 0.7 °(P <0.01); AOFAS the average score improved from 39.9 ± 8.3 preoperatively to postoperatively an annual average 87.3 ± 4.7 min(P <0.01). Group B: HVA decreased from preoperative average 35.6 ° ± 3.0 ° to 1 day after the average 16.6 ° ± 1.2(P <0.01), after an average annual 18.7 ° ± 2.0°(P <0.01); 1 ~ metatarsal angle between two IMA decreased from preoperative average 15.7 ° ± 2.5 ° to 1 day after an average 8.9 ° ± 0.7 °(P <0.01), after a year on average 9.8 ° ± 0.7°(P <0.01); AOFAS the average score improved from 40.5 ± 8.1 preoperatively to postoperatively an annual average 94.0 ± 4.3 min(P <0.01). Statistical analysis showed that: the former group and the plate group Kirschner surgery HVA(P = 0.565), IMA(P = 0.911), AOFAS score was no significant difference(P = 0.818), one day after both HVA(P = 0.737), IMA(P = 0.453) no significant difference, after a year, the group with the plate and group with the Kirschner HVA(P <0.05), IMA(P <0.05), AOFAS scores(P <0.05) were different. Function Rating: A group of gifted 6 feet, good in 11 feet, 3 feet difference, good rate 85.5%; group B were excellent in 12 feet, good seven feet, one foot difference, excellent rate of 95%.Conclusions:1 Juvenile hallux valgus patients within the first metatarsal osteotomy fixation, curative effect obviously, can significantly improve symptoms.2 Underwent the same procedure, Kirschner wire fixation and plate fixation effect groups no significant difference in the short term after surgery, Over time, Kirschner wire fixation and plate fixation two effects are statistically significant differences after 1 year, First metatarsal osteotomy application plate fixation is better than fixation with Kirschner wire applications.3 regardless of Kirschner wire fixation group or plate fixation group had postoperative recurrence of hallux valgus, hallux valgus which shows youths postoperative recurrence of their characteristics.