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Radiographic Results and Return to Activity After Sesamoidectomy for Fracture.
- Source :
-
Foot & ankle international [Foot Ankle Int] 2017 Oct; Vol. 38 (10), pp. 1100-1106. Date of Electronic Publication: 2017 Aug 11. - Publication Year :
- 2017
-
Abstract
- Background: Limited data are available comparing the results of lateral sesamoidectomy and medial sesamoidectomy for the treatment of fractures recalcitrant to nonoperative treatment interventions. The hypothesis of this study was that sesamoidectomy for either lateral or medial sesamoid fractures would not change radiographic alignment of the first ray given the use of identical reconstruction of the plantar plate, intersesamoid ligament, and plantar ligament complex at the time of surgery.<br />Methods: This retrospective cohort study compared the outcomes of 46 consecutive patients treated with sesamoidectomy (24 lateral, 22 medial). Patient demographics, mechanisms of injury, and outcomes were recorded. Preoperative, postoperative, and changes in both hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured.<br />Results: No statistically significant difference could be detected for age ( P = .577), sex ( P = .134), return to activity ( P = 1.000), likelihood to undergo the procedure again ( P = 1.000), orthotic use postoperatively ( P = 1.000), perioperative complications ( P = .497), duration of symptoms ( P = .711), or length of follow-up ( P = .609). While statistically significant changes in preoperative and postoperative alignment were detected for both medial and lateral sesamoidectomy, these changes were not clinically significant. Patients undergoing medial sesamoidectomy had higher preoperative and postoperative HVA and IMA compared with those undergoing lateral sesamoidectomy. Medial sesamoidectomy patients had a net increase in both HVA and IMA, while patients undergoing lateral sesamoidectomy had a net decrease in both HVA and IMA.<br />Conclusion: Although statistically significant changes in both HVA and IMA were detected, these values were too small to be considered clinically significant. Patient outcomes did not differ between the 2 groups, and sesamoidectomy was used with low patient morbidity for both medial and lateral sesamoid fractures that failed to respond to nonoperative modalities. These data suggest that the underlying mechanics of the foot may be different in patients who sustain medial and lateral sesamoid stress injury, suggesting a possible etiologic difference between medial and lateral sesamoid injuries.<br />Level of Evidence: Level III, retrospective cohort study.
- Subjects :
- Adult
Aged
Cohort Studies
Female
Follow-Up Studies
Fractures, Bone diagnostic imaging
Humans
Male
Middle Aged
Pain Measurement
Postoperative Care methods
Radiography methods
Recovery of Function
Retrospective Studies
Risk Assessment
Sesamoid Bones injuries
Time Factors
Toe Phalanges injuries
Toe Phalanges surgery
Young Adult
Fractures, Bone surgery
Osteotomy methods
Sesamoid Bones diagnostic imaging
Sesamoid Bones surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1944-7876
- Volume :
- 38
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Foot & ankle international
- Publication Type :
- Academic Journal
- Accession number :
- 28800707
- Full Text :
- https://doi.org/10.1177/1071100717717265