CAN THE PERCUTANEOUS CHEVRON AND AKIN (PECA) TECHNIQUE CORRECT THE PRONATION OF THE FIRST METATARSAL IN HALLUX VALGUS?

ABSTRACT Objective Pronation of the first metatarsal in hallux valgus has recently been discussed among foot and ankle surgeons. This study aimed to evaluate the potential radiographic correction of moderate and severe hallux valgus using the percutaneous Chevron and Akin (PECA) technique. Methods We evaluated 45 feet in 38 patients (mean age 65.3 years old [36 - 83]; 4 men; 34 women; 7 bilateral) who underwent surgical correction using the PECA technique. The radiographic images evaluated were anteroposterior radiographs obtained pre- and postoperatively at least 6 months after surgery, including the metatarsophalangeal angle, the intermetatarsal angle, pronation of the first metatarsal, displacement of the distal fragment, medial sesamoid position and bone union. Results All parameters evaluated showed significant postoperative improvement, including correction of pronation of the first metatarsal (p摘要 【目的】拇外翻（hallux valgus）患者第一跖骨（first metatarsal）旋前的相关问题近期备受足踝外科医师关注。本研究旨在评估经皮Chevron-Akin（percutaneous Chevron and Akin, PECA）术式对中重度拇外翻患者的影像学矫正效果。 【方法】本研究纳入38例接受该术式矫正的患者，共计45足；患者平均年龄65.3岁，年龄区间为36~83岁，其中男性4例、女性34例，7例为双侧足部病变。本研究评估的影像学资料为术前及术后至少6个月拍摄的患足正位X线片（anteroposterior radiographs），观测指标包括跖趾关节角（metatarsophalangeal angle）、跖骨间角（intermetatarsal angle）、第一跖骨旋前程度、远端骨块移位情况、内侧籽骨位置及骨愈合情况。 【结果】所有观测指标术后均获得显著改善，其中包括第一跖骨旋前的矫正（p