摘要
目的探讨第1跖骨楔形外翻截骨术治疗拇外翻的临床效果。方法对80例中、重度拇外翻患者行第1跖骨楔形外翻截骨术治疗。记录术后患足感染情况、截骨切口及截骨端愈合情况以及并发症发生情况。比较手术前后AOFAS踝-后足评分、拇外翻角(HVA)、跖骨间角(IMA)、跖骨远端关节面夹角(DMAA)。结果患者均获得随访,时间7~24个月。未出现拇内翻、跖骨头坏死及跖趾关节炎,截骨切口及截骨端愈合良好。1例发生感染、2例出现拇趾内侧麻木,经对症治疗后愈合或缓解。术后12周和末次随访时,患足AOFAS踝-后足评分均较术前显著升高(P<0.05),HVA、IMA、DMAA均较术前显著降低(P<0.05)。结论第1跖骨楔形外翻截骨术治疗中、重度拇外翻效果显著,安全性较高。
Objective To explore the clinical effect of the first metatarsal wedge valgus osteotomy in the treatment of hallux valgus.Methods The first metatarsal wedge valgus osteotomy was performed in 80 patients with moderate-severe hallux valgus.The infection situation of affected foot,the healing situation of osteotomy incision and osteotomy end,and the complications were recorded.AOFAS ankle-hindfoot score,hallux valgus angle(HVA),intermetatarsal angle(IMA)and distal metatarsal articular angle(DMAA)were compared before and after operation.Results All patients were followed up for 7~24 months.There was no hallux varus,metatarsal head necrosis and metatarsophalangeal arthritis.The osteotomy incision and osteotomy end healed well.Infection occurred in 1 case;numbness of the medial hallux occurred in 2 cases,and healed or relieved after symptomatic treatment.At 12 weeks postoperation and the last follow-up,the AOFAS ankle-hindfoot score of the affected foot was significantly increased than that before operation(P<0.05),and the HVA,IMA and DMAA were significantly decreased than those before operation(P<0.05).Conclusions The first metatarsal wedge valgus osteotomy is effective and safe in the treatment of moderate-severe hallux valgus.
作者
杨克敏
侯开宇
蒙顺
YANG Ke-min;HOU Kai-yu;MENG Shun(Dept of Bone and Trauma Surgery,the Second People′s Hospital of Yunnan Province,Kunming,Yunnan 650021,China)
出处
《临床骨科杂志》
2020年第5期659-661,共3页
Journal of Clinical Orthopaedics
关键词
拇外翻
楔形外翻截骨
足功能评分
拇外翻角
跖骨间角
hallux valgus
wedge valgus osteotomy
foot function score
hallux valgus angle
intermetatarsal angle
