Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
[Clinical study of Ilizarov technique combined with "joystick technique" in treatment of fourth brachymetatarsia].
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Liang Jiachang, Feng Enhui, Guan Hua, Chen Pu, He Jianbo, Huang Weiming, Xu Yiyin, Xie Jiewei
Аннотация
OBJECTIVE: To evaluate the effectiveness and safety of Ilizarov technique combined with the "joystick technique" for the treatment of fourth brachymetatarsia.
METHODS: A retrospective analysis was performed on 53 patients with fourth brachymetatarsia who met the selection criteria and were treated between August 2021 and January 2025. Patients were divided into two groups according to the surgical method: group A (Ilizarov combined with "joystick technique", n=19) and group B (Ilizarov alone, n=34). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, side, preoperative fourth metatarsal length, preoperative shortening of the fourth metatarsal, and American Orthopaedic Foot and Ankle Society (AOFAS) score. The operation time, intraoperative fluoroscopy frequency, total hospitalization costs, and complications were recorded and compared between groups. Metatarsal length was measured preoperatively and at 3 months postoperatively to calculate the lengthening amount. Foot function was evaluated using the AOFAS score preoperatively and at 4 months postoperatively. Patient satisfaction was assessed using a self-designed scale at 4 months postoperatively.
RESULTS: All surgeries were successfully completed. The operation time and intraoperative fluoroscopy frequency were significantly lower in group A than in group B ( P<0.05), while total hospitalization costs showed no significant difference (P>0.05). All patients were followed up, with a follow-up of (6.26±1.52) months in group A and (6.70±1.55) months in group B ( t=-0.978, P=0.333). At 3 months postoperatively, the metatarsal lengthening was comparable between the two groups, with no significant difference ( P>0.05). At 4 months postoperatively, AOFAS scores improved in both groups when compared with preoperative values, and the change in AOFAS score was greater in group A than in group B, the differences were significant ( P<0.05). There were 2 cases of metatarsophalangeal joint stiffness and 1 case of metatarsophalangeal joint dislocation in group A, and 2 cases of nonunion, 2 cases of metatarsophalangeal joint dislocation, 3 cases of metatarsophalangeal joint dislocation with metatarsophalangeal joint stiffness, and 8 cases of simple metatarsophalangeal joint stiffness in group B. No pin-tract infection occurred in either group. The overall incidences of complications were 15.8% in group A and 44.1% in group B, with a significant difference ( P<0.05). At 4 months postoperatively, patient satisfaction in group A was significantly better than that in group B ( P<0.05).
CONCLUSION: The Ilizarov technique combined with the "joystick technique" can significantly optimize surgical efficiency, reduce intraoperative trauma and the risk of complications, and promote better functional recovery and patient satisfaction. It represents a favorable option for the treatment of fourth brachymetatarsia.
METHODS: A retrospective analysis was performed on 53 patients with fourth brachymetatarsia who met the selection criteria and were treated between August 2021 and January 2025. Patients were divided into two groups according to the surgical method: group A (Ilizarov combined with "joystick technique", n=19) and group B (Ilizarov alone, n=34). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, side, preoperative fourth metatarsal length, preoperative shortening of the fourth metatarsal, and American Orthopaedic Foot and Ankle Society (AOFAS) score. The operation time, intraoperative fluoroscopy frequency, total hospitalization costs, and complications were recorded and compared between groups. Metatarsal length was measured preoperatively and at 3 months postoperatively to calculate the lengthening amount. Foot function was evaluated using the AOFAS score preoperatively and at 4 months postoperatively. Patient satisfaction was assessed using a self-designed scale at 4 months postoperatively.
RESULTS: All surgeries were successfully completed. The operation time and intraoperative fluoroscopy frequency were significantly lower in group A than in group B ( P<0.05), while total hospitalization costs showed no significant difference (P>0.05). All patients were followed up, with a follow-up of (6.26±1.52) months in group A and (6.70±1.55) months in group B ( t=-0.978, P=0.333). At 3 months postoperatively, the metatarsal lengthening was comparable between the two groups, with no significant difference ( P>0.05). At 4 months postoperatively, AOFAS scores improved in both groups when compared with preoperative values, and the change in AOFAS score was greater in group A than in group B, the differences were significant ( P<0.05). There were 2 cases of metatarsophalangeal joint stiffness and 1 case of metatarsophalangeal joint dislocation in group A, and 2 cases of nonunion, 2 cases of metatarsophalangeal joint dislocation, 3 cases of metatarsophalangeal joint dislocation with metatarsophalangeal joint stiffness, and 8 cases of simple metatarsophalangeal joint stiffness in group B. No pin-tract infection occurred in either group. The overall incidences of complications were 15.8% in group A and 44.1% in group B, with a significant difference ( P<0.05). At 4 months postoperatively, patient satisfaction in group A was significantly better than that in group B ( P<0.05).
CONCLUSION: The Ilizarov technique combined with the "joystick technique" can significantly optimize surgical efficiency, reduce intraoperative trauma and the risk of complications, and promote better functional recovery and patient satisfaction. It represents a favorable option for the treatment of fourth brachymetatarsia.