S.E.R.I. 수술법을 이용한 소건막류의 치료

Abstract

Purpose: The purpose of this study was to evaluate the clinical and radiological outcomes of the S.E.R.I. (simple, effective, rapid, inexpensive) operation for the bunionette deformity. Materials and Methods: Between March 2005 and February 2009, 22 patients (26 feet) who had been treated for the bunionette deformity with minimally invasive osteotomy were reviewed retrospectively. Clinically, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, shoes selectivity, disappearance of callus and patient’s satisfaction level by Coughlin scoring system were evaluated. Radiologically, the bunionette was classified as four types according to the Fallat classification. The 4-5th intermetatarsal angle (4-5th IMA), the 5th metatarsophalangeal angle (5th MPA) and the length of 5th metatarsal bone (5th MTL) were analyzed at preoperatively and at final follow up visit. Results: VAS improved from 6.8±1.8 points to 2.2±1.8 points (p<0.05). AOFAS score improved from 54.0±14.2 points to 90.0±4.8 points (p<0.05). There was no change in shoes selectivity. 9 feet (34.6%) were satisfied with excellent results, 16 feet (61.5%) with good results and 1 foot (3.9%) with fair results. The average 4-5th IMA was corrected from 10.1±2.3° to 4.4±1.7° (p<0.05). The average 5th MPA was corrected from 11.5±8.6° to -0.1±4.1° (p<0.05). The average 5th MTL was changed from 66.1±4.3 millimeters to 64.1±4.4 millimeters (p=0.069). There was no malunion, nonunion or delayed union and other perioperative complications. Conclusion: S.E.R.I. operation is less invasive and easy technique. This procedure is recommendable for the treatment of the bunionette deformity.