摘要
目的 探讨第1跖骨基底截骨结合Chevron-Gerbert手术治疗严重[足母]外翻畸形的临床疗效.方法 2004年6月至2008年8月利用第1跖骨基底截骨结合Chevron-Gerbert手术治疗重度[足母]外翻患者37例（66足）,男性5例（10足）,女性21例（38足） 年龄21～76岁,平均58岁.术前、术后、随访时均拍摄足部负重位正、侧位X线片,测量[足母]外翻角、第1、2跖骨间角、近侧关节固定角.比较术前、术后6周、末次随访时（足母）外翻相关各角度的X线测量值,并结合美国足踝外科协会（AOFAS）的Maryland评分法观察疗效.结果 本组患者26例（48足）得到随访,随访时间1～4年,平均2.3年.末次随访时（足母）外翻角较术前纠正25.6°±3.8°,第1、2跖骨间角较术前纠正8.6°±2.4°,近侧关节固定角较术前纠正4.7°±4.2°.根据AOFAS百分评分法评定,优15例（28足）、良8例（16足）、可3例（4足）,优良率为91.7%.结论 利用第1跖骨基底截骨结合Chevron-Gerbert手术治疗严重[足母]外翻畸形的临床疗效良好,但有手术相对复杂、需行多段截骨及内固定等缺点.
Objective To evaluate the clinical efficacy of treatment on the cases of severe hallux valgus by the first metatarsal basal osteotomy combined with Chevron-Gerbert operation. Methods From June 2004 to August 2008, 37 cases of severe hallux valgus （66 feet） underwent first metatarsal basal osteotomy combined with Chevron-Gerbert operation. There were 5 males （10 feet ） and 21 females （38 feet）, aged 21-76 years （mean 58 years）. For all patients with follow-up, radiographic measurements of frontal and lateral position of foot were taken to measure the hallux valgus angle （ HVA）, the IMA （intermetatarsal angle） and the proximal articular set angle （PASA） preoperatively, postoperatively and in follow-up respectively. The measuring results were compared among the preoperative, the 6-week postoperative and the final follow-up. At the same time the patients were evaluated with the AOFAS Maryland score. Results Of the original 37 patients, 26 patients （48 feet） were followed up. The mean durations of follow-up was 2. 3 years （range from I to 4 years）. At final follow-up, HVA corrected 25.6°±3.8°, IMA corrected 8.6°± 2.4°, and PASA corrected 4. 7°± 4. 2°. According to AOFAS rating system, 91.7% patients were rated as excellent or good with excellent in 15 patients （28 feet）, good in 8 patients （ 16 feet）, and fair in 3 patients （4 feet）. Conclusions First metatarsal basal osteotomy combined with Chevron-Gerbert operation has good efficacy to the patients with severe hallux valgus. However there are disadvantages such as complexity relatively for multi-stage osteotomy and internal fixation.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2010年第21期1633-1636,共4页
Chinese Journal of Surgery
