[1]王琪,李克锋,黄文泽,等.影响拇趾外翻患者矫正手术效果的因素分析[J].中国中医骨伤科杂志,2024,32(01):48-53.[doi:10.20085/j.cnki.issn1005-0205.240109]
　WANG Qi,LI Kefeng,HUANG Wenze,et al.Analysis of Factors Influencing the Efficacy of Corrective Surgery in Patients with Hallux Valgus[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(01):48-53.[doi:10.20085/j.cnki.issn1005-0205.240109]
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影响拇趾外翻患者矫正手术效果的因素分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年01期
页码:
48-53
栏目:
临床研究
出版日期:
2024-01-15

文章信息/Info

Title:
Analysis of Factors Influencing the Efficacy of Corrective Surgery in Patients with Hallux Valgus
文章编号:
1005-0205(2024)01-0048-06
作者:
王琪1; 李克锋1; 黄文泽1; 王欣1; 郭磊1△
1云南中医药大学第三附属医院(昆明市中医医院)骨伤科(昆明,650500)
Author(s):
WANG Qi1; LI Kefeng1; HUANG Wenze1; WANG Xin1; GUO Lei1△
1Orthopedics and Traumatology Department,The Third Affiliated Hospital of Yunnan University of Chinese Medicine(Kunming Municipal Hospital of Traditional Chinese Medicine),Kunming 650500,China.
关键词:
拇趾外翻;  矫正手术;  曼彻斯特-牛津足部问卷;  复发;  转移性跖骨痛;  糖尿病;  重度畸形;  危险因素
Keywords:
hallux valgus;  corrective surgery;  Manchester-Oxford foot questionnaire;  relapse;  metastatic metatarsal pain;  diabetes;  severe deformity;  risk factors
分类号:
R684.2
DOI:
10.20085/j.cnki.issn1005-0205.240109
文献标志码:
A
摘要:
目的:探讨影响拇趾外翻患者矫正手术效果的因素,为临床手术治疗提供参考。方法:回顾性收集2017年11月至2022年11月收治的因拇趾外翻行矫正手术治疗的186例患者临床资料,术前、术后末次随访均采用曼彻斯特-牛津足部问卷(MOXFQ)评估手术效果,根据术后末次随访和术前MOXFQ评分的差值将患者分为改善组和无改善组。收集相关临床资料,采用多因素Logistic回归分析影响拇趾外翻患者矫正手术效果的因素。结果:术后38例患者畸形无改善,148例患者畸形改善。无改善组年龄大于改善组,差异有统计学意义(P<0.05); 女性、糖尿病、吸烟史、周围血管疾病、美国麻醉医师协会(ASA)分级>1级、重度畸形、术后拇趾外翻复发和转移性跖骨痛比例高于改善组,差异有统计学意义(P<0.05); 微创术式比例低于改善组,差异有统计学意义(P<0.05); 术后末次随访美国足踝关节协会(AOFAS)评分及Maryland足部评分低于改善组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示术后拇趾外翻复发、转移性跖骨痛、糖尿病、术前重度畸形是拇趾外翻患者矫正手术无改善的危险因素,差异有统计学意义(P<0.05); 微创术式是保护因素,差异有统计学意义(P<0.05)。结论:术后拇趾外翻复发、转移性跖骨痛、糖尿病、术前重度畸形与拇趾外翻患者矫正手术效果较差有关,微创术式可改善手术效果。
Abstract:
Objective:To explore the factors affecting the efficacy of corrective surgery in patients with hallux valgus,and to provide reference for clinical surgical treatment.Methods:186 patients who received corrective surgery for bunion valgus from November 2017 to November 2022 were retrospectively collected.The results of surgery were evaluated by Mancunian-Oxford foot questionnaire(MOXFQ)before and after the last follow-up.Patients were divided into improved group and non-improved group according to the difference of MOXFQ score between last postoperative follow-up and preoperative.The related clinical data were collected and the factors influencing the efficacy of corrective surgery for patients with hallux valgus were analyzed by multivariate logistic regression.Results:There was no improvement in 38 patients and improvement in 148 patients.The age of the no-improvement group was higher than that of the improvement group(P<0.05),the proportions of female,diabetes,smoking history,peripheral vascular disease,American society of aneshesiologists(ASA)grade >1,severe deformity,postoperative recurrence of bunion and metastatic metatarsal algia were higher than those of the improvement group(P<0.05),and the proportions of minimally invasive surgery were lower than those of the improvement group(P<0.05).The American orthopedic foot and ankle society(AOFAS)score and Maryland foot score in the last postoperative follow-up were lower than those in the improved group(P<0.05).Multivariate logistic regression analysis showed that postoperative recurrence of bunion valgus,metastatic metatarsal algia,diabetes and preoperative severe deformity were risk factors for no improvement in bunion valgus patients(P<0.05),and minimally invasive surgery was protective factor(P<0.05).Conclusion:Postoperative recurrence of bunion valgus,metastatic metatarsal algia,diabetes mellitus,and severe deformity before surgery are associated with poor surgical results in bunion valgus patients.Minimally invasive surgery can improve surgical results.

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备注/Memo

备注/Memo:
△通信作者 E-mail:guolei73@hotmail.com
更新日期/Last Update: 2024-01-15