[1]顾鸿程 梁杰 崔恒燕△.第一跖骨基底闭合楔形截骨联合远端软组织平衡手术治疗中重度外翻25例[J].中国中医骨伤科杂志,2021,29(02):60-63.
 GU Hongcheng LIANG Jie CUI Hengyan.Clinical Report of 25 Cases for Wedge Osteotomy of the FirstMetatarsal Base Combined with the Balance of the DistalSoft Tissue in Treating Moderate and Severe Hallux Valgus[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(02):60-63.
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第一跖骨基底闭合楔形截骨联合远端软组织平衡手术治疗中重度外翻25例()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年02期
页码:
60-63
栏目:
临床报道
出版日期:
2021-02-15

文章信息/Info

Title:
Clinical Report of 25 Cases for Wedge Osteotomy of the FirstMetatarsal Base Combined with the Balance of the DistalSoft Tissue in Treating Moderate and Severe Hallux Valgus
文章编号:
1005-0205(2021)02-0060-04
作者:
顾鸿程1 梁杰1 崔恒燕1△
1江苏无锡市中医医院创伤骨科(江苏 无锡,214071)
Author(s):
GU Hongcheng1 LIANG Jie1 CUI Hengyan1△
1Department of Orthopaedic Trauma,Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214071,Jiangsu China.
关键词:
外翻 楔形截骨 闭合 中重度 远端软组织平衡手术
Keywords:
hallux valgus wedge osteotomy closed moderate and severe degree balance of the distal soft tissue
分类号:
R682.1
文献标志码:
B
摘要:
目的:总结采用第一跖骨基底闭合楔形截骨联合远端软组织平衡手术治疗中重度外翻的疗效。方法:自2012年1月至2019年12月,对25例(28足)中重度外翻患者采用第一跖骨基底楔形截骨联合远端软组织平衡手术治疗,测量手术前后外翻角(HAA)及跖间角(IMA)变化情况,并采用美国足踝外科协会(AOFAS)第一跖骨、趾骨及跖趾关节、趾间关节功能评分标准评定手术前后功能。结果:切口均Ⅰ期愈合,无感染,无内固定失败,无截骨部延迟愈合或不愈合。患者外翻畸形纠正明显,囊炎、转移性跖痛症均明显改善,未见畸形复发。术后测量HAA(9.643°±2.041°)及IMA(6.714°±1.357°)均较术前(分别为(43.286°±6.531°)和(20.464°±3.144°))明显减小,差异有统计学意义(P<0.01); AOFAS评分也从术前(49.786±9.480)分显著提高为末次随访的(91.750±4.169)分,差异有统计学意义(P<0.01)。结论:采用第一跖骨基底闭合楔形截骨联合远端软组织平衡手术治疗中重度外翻,是一种安全有效的治疗方法。
Abstract:
To report the clinical efficacy of the treatment of moderate and severe hallux valgus by closed cuneiform osteotomy of the first metatarsal base combined with the balance of the distal soft tissue.Methods:25 cases(28 feet)of moderate and severe hallux valgus were treated by closed cuneiform osteotomy of the first metatarsal base combined with the balance of the distal soft tissue in our department from January 2012 to December 2019.The hallux abductus angle(HAA)and the inter metatarsal angle(IMA)were measured before and after operation.Functional evaluation were carried out according to the American orthopedic foot and ankle society(AOFAS)score system before the operation and in the last follow-up.Results:All the patients had incision healing at the first stage.The follow-ups revealed no incidence of internal fixation failure or delayed union or no union.All valgus deformities,pollicis,metatarsal pain were improved satisfactorily without recurrence.The preoperative HAA and IMA(43.286°±6.531° and 20.464°±3.144°)decreased significantly,as compared with them before the surgery(9.643°±2.041° and 6.714°±1.357°)(P<0.01).The AOFAS score was improved significantly from 49.786±9.480 before the treatment to 91.750±4.169 in the last follow-up(P<0.01).Conclusion:Closed wedge osteotomy of the first metatarsal base combined with the balance of the distal soft tissue is a safe and effective way in the treatment of moderate and severe degree hallux valgus.

参考文献/References:

[1] 王正义.足踝外科学[M].2版.北京:人民卫生出版社,2014:83-129.
[2] 胡永成,邱贵兴,马信龙,等.骨科疾病疗效评价标准[M].北京:人民卫生出版社,2012:255-256.
[3] 温建民.外翻诊断与治疗方法选择的探讨[J].中国骨伤,2018,31(3):199-202.
[4] THORDARSON D B.足踝外科学精要[M].张建中,译.北京:北京大学医学出版社,2013:124-141.
[5] KANALE S T.坎贝尔骨科手术学第8卷:足踝外科[M].王岩,译.北京:人民军医出版社,2015: 3527-3622.
[6] 杨杰,梁晓军,李毅,等.第1跖骨双截骨+Akin截骨治疗成人重度外翻畸形[J].美中国际创伤杂志,2017,16(4):34-36.
[7] 张惠,李威.第一跖骨基底部楔形截骨联合改良Mcbride手术治疗中重度外翻[J].中国临床研究,2020,33(1):62-65.
[8] 毛威,张建中,孙超,等.基底楔形闭合截骨治疗外翻的几何学特征[J].中国组织工程研究,2018,22(7):1056-1065.
[9] TURNBULL T,GRANGE W.A comparison of Keller’s arthroplasty and distal metatarsal osteotomy in the treatment of adult hallux valgus[J].J Bone Joint Surg Br,1986,68(1):132-137.
[10] 桑志成,温建民,孙卫东,等.中西医结合微创技术治疗外翻的几点思考[J].中国中医骨伤科杂志,2010,18(5):59-60.

备注/Memo

备注/Memo:
通信作者 E-mail:cuihengyan@163.com
更新日期/Last Update: 2021-02-15