Prevalence of chronic pain syndrome in patients who have undergone hallux valgus percutaneous surgery: a comparison of sciatic-femoral and ankle regional ultrasound-guided nerve blocks

Biz, Carlo; Iudicibus, Gianfranco de; Belluzzi, Elisa; Dalmau-Pastor, Miki; Bragazzi, Nicola Luigi; Funes, Manuela; Parise, Gian-Mario; Ruggieri, Pietro

doi:10.1186/s12891-021-04911-4

Cited by 11 publications

(6 citation statements)

References 55 publications

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“…A femoral-sciatic nerve block or ankle block regional anesthesia was safe and effective in reducing postoperative pain, with a low incidence of chronic pain syndrome. However, it is just for mild-tomoderate HV (without concomitant forefoot procedures: e.g., hammertoe correction, claw toe correction) [21]. A bigger drawback is that the surgeon cannot use a tourniquet for this type of analgesia.…”

Section: Discussionmentioning

confidence: 99%

Pain Management of Hallux Valgus Surgery Is Achieved by Cocktail Therapy

Xie

Zhu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. Hallux valgus is a relatively common forefoot disease in clinical practice. The aim of our study was to assess the role of local cocktail drugs and postoperative pain after hallux valgus surgery. Methods. A retrospective case-control study was conducted to analyze 75 moderate to severe hallux valgus patients from June 1, 2018 to December 1, 2019. All patients were divided into cocktail and control groups according to whether the cocktail therapy was used or not after the operation. The anesthesiologist did not provide analgesic treatment other than nerve block anesthesia and intravenous anesthesia, such as analgesic pumps. The operative region of the cocktail group received a mixture of 10 ml of 0.75% ropivacaine, 10 ml of flurbiprofen axetil injection, and 1 ml of compound betamethasone injection, whereas the control group received nothing in the surgical spot. We recorded patients’ VAS scores preoperatively and at 6, 24 hours postoperatively; the length of hospital stay and the number of hospitalization expenses; the scores of Kolcaba comfort level; and the scores of Pittsburgh sleep quality. Result. There was no significant difference in age or sex between the two groups. The VAS scores at 6 and 24 hours postoperatively were significantly lower in the cocktail group. The average length of hospital stay was 8.24 days in the control group and 3.73 days in the cocktail group. The average total hospitalization cost of the control group was ¥28285.16, and that of the cocktail group was ¥22366.31. In expenses of total hospitalization costs, the cocktail group was lower than the control group. Kolcaba’s comfort various scores and the total score of the cocktail group were higher than the control group. The total score of PSQI and all dimensions in the experimental group were lower than those in the control group. Conclusion. We found a significant difference in the results of postoperative pain management except for age, sex, and hospitalization expenses. After hallux valgus surgery, inject cocktail drugs around the first metatarsophalangeal joint did reduce postoperative pain level. Level of Evidence. Level III, case-control study.

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Section: Discussionmentioning

confidence: 99%

Pain Management of Hallux Valgus Surgery Is Achieved by Cocktail Therapy

Xie

Zhu

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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“…Second, evaluation for pain VAS was lacking in some of the enrolled studies. Although affected by the types of anesthesia, 24 the degree of postoperative pain has been reported to be different among the surgical procedures. 8 Third, there have been no controlled studies including patients with severe HV deformity, which have historically been corrected by proximally orientated osteotomies or arthrodesis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes of different osteotomy sites for hallux valgus: A systematic review and meta-analysis

Fukushi

Tanaka

Nishiyama

et al. 2022

J Orthop Surg (Hong Kong)

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Background Hallux valgus (HV) is a common foot deformity for which several corrective surgical procedures, with different osteotomy sites, have been reported. The purpose of the present study was to systematically review randomized (RCTs) or controlled (CCTs) clinical trials and perform meta-analysis on outcomes of different osteotomy sites of the first metatarsal. Methods An extensive literature search was conducted in PubMed and the Cochrane Library from January 1983 to July 2020. Studies were identified using the terms “hallux valgus” and “osteotomy”. We included RCTs or CCTs comparing different locations of osteotomy for the first metatarsal bone (distal vs. mid-shaft, distal vs. proximal, and mid-shaft vs. proximal). The surgical outcomes included postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), American Orthopaedic Foot and Ankle Society (AOFAS) score, pain visual analog scale (VAS) score, perioperative complications and recurrence of deformity. We enrolled 10 studies with a total of 793 feet in the qualitative synthesis following full-text screening. Results A majority of patients included in the enrolled trials showed mild to moderate deformity, with mean HVA <40°. Out of the 10 enrolled studies; six compared distal osteotomies with mid-shaft osteotomies and showed no significant differences in the surgical outcomes between the scarf and chevron groups; three RCTs compared distal osteotomies with proximal osteotomies with conflicting results, one RCT showed the superiority of proximal osteotomy while the other two RCTs showed equivalent outcomes; one study that compared between mid-shaft and proximal osteotomies showed equivalent outcomes between the groups. Conclusion For the management of mild to moderate HV deformity, we found no significant clinical and radiological differences between patients treated with scarf and chevron osteotomies. Further controlled trials comparing different sites of osteotomies for moderate to severe HV deformity are needed.

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“…Standard sterilization and draping techniques in the supine position with a tight pneumatic tourniquet were used for all patients underintraspinal or regional nerve anesthesia. And the regional nerves anesthesia was included femoral-sciatic nerve block or ankle block regional anaesthesia [ 18 ]. A 7 cm medial incision was made 1 cm distal to the first metatarsophalangeal joint over the hallux valgus and continuing proximally along the inferior margin of the first metatarsal, to the first metatarsocuneiform.…”

Section: Methodsmentioning

confidence: 99%

Rotation scarf + Akin osteotomy for severe hallux valgus with a new evaluation index: distance between the first and second metatarsals

Xie

Lü

et al. 2022

BMC Musculoskelet Disord

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Background Although rotation scarf + Akin osteotomy has been described for correcting hallux valgus deformity, the treatment efficacy of rotation scarf + Akin osteotomy for severe hallux valgus should be further studied. The purpose of our study was to evaluate the outcomes of rotation scarf + Akin osteotomy on severe hallux valgus. Methods We conducted a retrospective study of patients with hallux valgus who underwent surgery using rotation scarf + Akin osteotomy in our hospital between June 2014 and January 2020. The parameters evaluated include (1) the hallux valgus angle (HVA), (2) intermetatarsal angle (IMA), (3) distal metatarsal articular angle (DMAA), (4) tibial sesamoid position (TSP), (5) the length of first metatarsal bone and (6) ratio between the vertical distance from the lateral of the first metatarsal head to the medial of the second metatarsal head and the vertical distance of lateral of the second metatarsal head to the medial of the third metatarsal head (MT-I to II/II to III distance). A visual analog scale (VAS) was used to evaluate the degree of pain before and at the last follow-up after the operation. The American Orthopaedic Foot & Ankle Society (AOFAS) Forefoot Score wasassessed before and at the last follow-up after the operation. Patient satisfaction assessment was also conducted at the time. Results All radiological parameters including, HVA, IMA, DMAA and TSP,, significantly improved (p < 0.001). The length of the first metatarsal was shortened 3.1 mm on average. The MT-I to II/II to III distance was also reduced to 1.8 after surgery and 3.3 before surgery. The VAS score and AOFAS score was also statistically significant before operation and at the last follow-up after the operation (p < 0.001). Forty-one (82%) feet in patients were very satisfied or satisfied. Conclusion Rotation scarf + Akin osteotomy is demonstrated to be safe, effective, and feasible for correcting severe hallux valgus. It can obtain good long-term correction with a low incidence of recurrence and metatarsalgia. Postoperative satisfaction and functional recovery of patients are significantly improved. The MT-I to II/II to III distance, a new evaluation indicator, can be better evaluate the correction of hallux valgus.

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Prevalence of chronic pain syndrome in patients who have undergone hallux valgus percutaneous surgery: a comparison of sciatic-femoral and ankle regional ultrasound-guided nerve blocks

Cited by 11 publications

References 55 publications

Pain Management of Hallux Valgus Surgery Is Achieved by Cocktail Therapy

Pain Management of Hallux Valgus Surgery Is Achieved by Cocktail Therapy

Comparison of outcomes of different osteotomy sites for hallux valgus: A systematic review and meta-analysis

Rotation scarf + Akin osteotomy for severe hallux valgus with a new evaluation index: distance between the first and second metatarsals

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