Clinical study of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in the treatment for severe hallux valgus

Abstract

Objective To analyze the clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in the patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis. Methods From Apr. 2013 to Aug. 2015, 120 feet with severe hallux valgus were treated by operation in Beijing Friendship Hospital, Capital Medical University. Before operation, measured some angles, such as hallux valgus angle, intermetatarsal angle, proximal articular surficial intrinsic angle and so on in the two groups. And evaluated the patients condition by Maryland scale at the same time. Through the date, we make sure that there was no significant difference between the two groups before operation. According to the order of hospitalization, all patients were randomly divided into experimental group (n=60) and control group (n=60). The cases of experimental group were treated by Ludloff osteotomy and artificial joint replacement. The cases of control group were treated by Ludloff osteotomy and Akin osteotomy. We used the visual analogue scale, the core quality of life scale-36 and Maryland scale to record the date, such as pain, the range of motion and appearance of the metatarsophalangeal joint and the ability of daily life and sports before and after operation. Compared above categorical variables using paired T-test between before and after operation and using T-test between the two groups. Compared the rate of operative complications by Fisher′s exact test between the two groups. Results Through the Maryland scale, the total excellent rate of the experimental group (91.7%) was higher than the total excellent rate of the control group (75.0%), with statistically significant (P 0.05). The scores of quality of life of the experimental group after treatment were significantly higher than those of the control group, with statistically significant (P<0.05). The visual analogue scale pain score (1.61±0.12) of the experimental group was significantly lower than the control group (3.68±0.58), with statistically significant (P<0.05). Conclusion The clinical outcomes of Ludloff osteotomy and artificial metatarsophalangeal arthroplasty in patients with severe hallux valgus and metatarsophalangeal joint osteoarthritis is better, high safety, less trauma and faster recovery. It is worthy of promotion and use. Key words: Hallux valgus; Ludloff osteotomy; Replacement of artificial metatarsophalangeal joint; Treatment outcome; Comparative effectiveness research