TY - JOUR

T1 - Применение ускоренного протокола реабилитации после оперативного лечения приобретенного вальгусного отклонения первого пальца стопы

AU - Sergeev, GD

AU - Belen'kiy, IG

AU - Oleinik, AV

AU - Sergeeva, MA

AU - Razumova, KV

AU - Maiorov, BA

N1 - Times Cited in Web of Science Core Collection: 0 Total Times Cited: 0 Cited Reference Count: 19

PY - 2026

Y1 - 2026

N2 - Background. Hallux valgus (HV) is a common orthopedic deformity, and optimization of postoperative rehabilitation is considered one of the key factors in accelerating functional recovery after corrective osteotomies. The aim of the study - to evaluate the effectiveness of the developed accelerated postoperative rehabilitation protocol for patients who underwent open or minimally invasive hallux valgus correction. Methods. A prospective non-randomized comparative cohort study was conducted, including 120 patients older than 18 years with hallux valgus deformity. All patients underwent surgical treatment: open scarf osteotomy (n = 40) or minimally invasive MICA osteotomy (n = 80). After surgery, all patients were assigned an original accelerated rehabilitation protocol. Patients with pain intensity >= 6 points on the visual analog scale (VAS) at week 2 were transferred to the standard rehabilitation protocol. As a result, two groups were formed: accelerated protocol (AP, n = 74) and standard protocol (SP, n = 46). Pain intensity was assessed using the VAS at 4 and 8 weeks, 6 months, and 1 year; functional outcomes were evaluated using the AOFAS score at 8 weeks, 6 months, and 1 year; postoperative complication rates were also analyzed. Results. Patients in the AP group demonstrated significantly lower VAS pain scores compared with the SP group at 4 weeks (median 3.00 vs 5.00 points; p < 0.001), 8 weeks (1.00 vs 3.00 points; p < 0.001), and 6 months (0.00 vs 1.00 point; p < 0.001). At 1 year, no significant difference in VAS scores between the groups was observed (p = 0.364). Functional outcomes assessed by the AOFAS score at 8 weeks were higher in the AP group (median 65.00 points) compared with the SP group (52.00 points); p < 0.001. At 6 months (88.00 vs 82.00 points; p = 0.183) and 1 year (95.00 vs 92.00 points; p = 0.353), no significant differences were noted. Complication rates were comparable between the groups: 8.1% in the AP group and 6.5% in the SP group (p = 1.000). The AP group predominantly included patients who underwent minimally invasive MICA osteotomy (89.2%), whereas scarf osteotomy was more frequently performed in the SP group (69.6%; p < 0.001). Conclusion. The combination of a minimally invasive surgical technique and an accelerated rehabilitation protocol constituted an optimal treatment model, providing adequate deformity correction with minimal postoperative pain and reduced recovery time.

AB - Background. Hallux valgus (HV) is a common orthopedic deformity, and optimization of postoperative rehabilitation is considered one of the key factors in accelerating functional recovery after corrective osteotomies. The aim of the study - to evaluate the effectiveness of the developed accelerated postoperative rehabilitation protocol for patients who underwent open or minimally invasive hallux valgus correction. Methods. A prospective non-randomized comparative cohort study was conducted, including 120 patients older than 18 years with hallux valgus deformity. All patients underwent surgical treatment: open scarf osteotomy (n = 40) or minimally invasive MICA osteotomy (n = 80). After surgery, all patients were assigned an original accelerated rehabilitation protocol. Patients with pain intensity >= 6 points on the visual analog scale (VAS) at week 2 were transferred to the standard rehabilitation protocol. As a result, two groups were formed: accelerated protocol (AP, n = 74) and standard protocol (SP, n = 46). Pain intensity was assessed using the VAS at 4 and 8 weeks, 6 months, and 1 year; functional outcomes were evaluated using the AOFAS score at 8 weeks, 6 months, and 1 year; postoperative complication rates were also analyzed. Results. Patients in the AP group demonstrated significantly lower VAS pain scores compared with the SP group at 4 weeks (median 3.00 vs 5.00 points; p < 0.001), 8 weeks (1.00 vs 3.00 points; p < 0.001), and 6 months (0.00 vs 1.00 point; p < 0.001). At 1 year, no significant difference in VAS scores between the groups was observed (p = 0.364). Functional outcomes assessed by the AOFAS score at 8 weeks were higher in the AP group (median 65.00 points) compared with the SP group (52.00 points); p < 0.001. At 6 months (88.00 vs 82.00 points; p = 0.183) and 1 year (95.00 vs 92.00 points; p = 0.353), no significant differences were noted. Complication rates were comparable between the groups: 8.1% in the AP group and 6.5% in the SP group (p = 1.000). The AP group predominantly included patients who underwent minimally invasive MICA osteotomy (89.2%), whereas scarf osteotomy was more frequently performed in the SP group (69.6%; p < 0.001). Conclusion. The combination of a minimally invasive surgical technique and an accelerated rehabilitation protocol constituted an optimal treatment model, providing adequate deformity correction with minimal postoperative pain and reduced recovery time.

KW - hallux valgus

KW - forefoot deformity

KW - rehabilitation

KW - corrective osteotomy

KW - scarf

KW - MICA

KW - CHEVRON OSTEOTOMY

KW - TRIAL

U2 - 10.17816/2311-2905-17815

DO - 10.17816/2311-2905-17815

M3 - статья

VL - 32

SP - 75

EP - 85

JO - ТРАВМАТОЛОГИЯ И ОРТОПЕДИЯ РОССИИ

JF - ТРАВМАТОЛОГИЯ И ОРТОПЕДИЯ РОССИИ

SN - 2311-2905

IS - 1

ER -