Efficacy Analysis Of Wen’s Procedure For Treat Severe Hallux Valgus

Objective:To investigate the clinical effects of the treatment of severe hallux valgus with Wen’s procedure(minimal incision osteotomy).Method:The method used in our study is retrospectively analysis for the severe hallux valgus patients since Jan2007to Jan2011. Wen’s procedure operation has been performed in the2nd joint department of Wangjing Hospital, and66cases (103feet) were followed up for more than10months. We followed up by Anterior-Posterior and lateral weight-bearing X-ray of feet at before and after opertation, and we have completely preoperative and postoperative data, included HAV (hallux valgus angle), IM angle (the Is’and2nd inter-metatarsal angle), AOFAS score, ROM of Is1MTPJ (metatarsophalangeal joint) and TSP(The tibial sesamoid position), which were retrospectively and statistically analyzed. The data used paired t-test and non-parametric test of two paired samples by SPSS16.0for analysis and processing,so as to discuss the actual efficacy of the Wen’s Procedure to treat severe hallux valgus.Results:The follow-up was performed on66patients, ranging from10months to31months, mean14.61months. Between19to75years of age, average was56.55years old; left foot55cases, accounting for53.40%; right foot48cases, accounting for46.60%;37patients with both feet,29patients with only one foot;2males(4feet), accounting for3.88%; female64casesa (99feet), accounting for96.12%.The results of our study showed that the HAV Angle reduced mean26.58°after operation(43.43°±6.00°to16.85°±6.59°); the IM Angle reduced mean5.94°(13.88°±3.18°to7.94°±2.88°); TSP reduced mean2.80(6.50°0.85to3.70±0.96); The score of AOFAS increased mean42.51(48.00±14.14to90.51±6.77), both of these data have been statistically analyzed, then there are statistical ly significant differences for the significance level of p<0.01. The ROM of lstMTPJ change from63.16°±18.70°to62.60°±12.41°, reduced mean0.56°after operation, so it showed no significant difference (p=0.21). Follow-up66cases (103feet),73feet have fore-foot pain before surgery, accounting for70.87%,62feet have fore-foot pain after surgery, it have no pain inll foot (10.68%), have no patients who have not pain before and suffer pain after operation, but pain aggravated in4feet (3.83%), and reduce in29foot (28.16%), lower incidence of metastatic metatarsal pain. Conclusion:In conclusion, we state that Wen’s Procedure for severe hallux valgus has significant clinical effects, because of HAV angle and IM angle reduced, TSP improved, the AOFAS score increased, the ROM of1st MTPJ change is not obvious after opteration in our study.