摘要
[目的]探讨改良Austin手术治疗外翻的手术适应证、手术方法和疗效。[方法]自1998年10月～2006年4月采用改良Austin手术治疗外翻患者34例62足,男13例22足,女21例40足;年龄32～67岁,平均43岁。术前、术后2周、随访时分别摄负重位X线片,测量外翻角(HVA)、第1、2跖骨间角(IMA)、近端关节固定角(PASA)、远端关节固定角(DASA),并观察其变化和测量角度数据进行对比分析。手术方法根据患者术前症状和测量角度个体化选择Austin手术改良式即chevron-gerbert或chevron-youngswick截骨术。[结果]全部获得随访,随访时间1～8年,平均3.6年;患者外翻角(HVA)术前为33.50°±1.02°,术后为13.6°±0.826°;第1、2跖骨间角(IMA)术前为16.0°±0.837°,术后为8.6°±1.078°;根据美国足与踝关节协会AOFAS制定的足趾功能评分标准评价。AOFAS评分术前为(44.8±5.7)分,术后为(87.6±4.2)分。优46足,良10足,可5足,差1足,优良率90.3%。[结论]改良Austin手术是治疗外翻畸形的一种操作简单、疗效可靠的手术方法。尤其更适合矫正PA-SA增大的重度外翻。对年龄较轻的轻、中度外翻患者手术应尽量不必干扰内收肌和籽骨也可达到矫形的目的。
[Objective] To retrospectively study and discuss the indications, surgical techniques and effect of treating hal- lux valgus with modified Austin operation -Chevron- Gerbert osteotomy or Chevron- Youngswick osteotomy. [Method] From October 1998 to April 2006, 34 patients （62 feet） with hallux valgus were treated with modified Austin operation. The X -ray films of all patients were collected preoperatively, two weeks postoperatively and during the follow - up. The hallux valgus angle （HVA） , intermetataral angle （IMA）, proximal articular set angle （PASA） and distal articular set angle （DASA） were measured and analyzed on radiogram. [ Result] All patients were followed up for 1 - 8 years （ mean 3.6 years） . HVA before and after surgery was 33.50°±1.02°and 13.60°±0.826° respectively. IMA was 16.0°±0.837°before and 8.60°±1.078° after surgery. AOFAS score was 44.8±5.7 before, and 87.6±4.2 after surgery. Significant difference was found between the results. According to AOFAS rating system, 46 feets had a excellent result and 10 feet had a good result and the other 5 feet had a fair re- suit. The rate of excellent or good results was 90.3%. [Conclusion] The modified Austin operation is a good, simple and reliable operation means for treatment of hallux valgus, which especially applies to severe hallux valgus with big PASA. The adductor hallucis or the sesamoid is not necessarily interfered in patients with slight or moderate hallux valgus.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第23期1787-1789,共3页
Orthopedic Journal of China
