摘要
目的总结经皮截骨闭合穿针治疗中、重度拇外翻的治疗方法及临床效果。方法 2005年2月-2009年7月,收治197例中、重度拇外翻患者。年龄17～76岁,平均46.5岁。女168例,男29例,双足182例,单足15例。拇外翻根据Mann的分类方法:中度152例291足,重度45例88足。根据术前双足的负重位及非负重位X线正、侧位摄片检查,采用小切口微创技术经皮截骨闭合穿针治疗中、重度拇外翻。结果术后切口均Ⅰ期愈合。185例获随访,随访时间9.5个月-5.2年。术后185例足拇外翻畸形完全矫正、无复发,患足无明显疼痛,第1跖趾关节活动范围正常,X线片检查第1跖骨截骨端均获临床愈合,截骨端临床愈合时间为5-7周,平均6周。采用美国足与踝关节协会(AOFAS)拇趾评分系统:优163例,良18例,可4例,优良率97.8%。结论经皮截骨闭合穿针治疗中、重度拇外翻具有损伤小、痛苦少、矫正彻底且不易复发的优点;操作简单,费用低廉,是治疗中、重度拇外翻的理想方法。
Objective To summarize the treatment method and clinical efficacy of percutaneous osteotomy through closing puncture in the treatment of moderate and severe hallux valgus. Methods From February 2005 to July 2009, a total of 197 cases with moderate and severe hallux valgus were treated. The mean age was 46.5 years old （range, 17-76y）. They were 168 females, 29 males （with 182 in double feet, and 15 in single foot）. According to the classification of Mann method, 152 patients were with moderate 291 feet, and 45 cases with 88 severe feet. According to the preoperative X-ray examination through normal and lateral positions for feet in the weight-bearing location and non-weight-bearing location, percutaneous osteotomy through closing puncture by adopting minimally invasive technique was performed in the treatment of moderate and severe hallux valgus. Results All incisions were healed by first intention post-operatively. 185 patients were followed up for 9.5 months to 5.2 years. Post-operatively, 185 patients obtained total correction of hallux valgus deformity in foot, with no recurrence and no significant foot pain. The first metatarsophalangeal joint had normal range of motion. According to X-ray results, the first metatarsal bone end with osteotomy obtained clinical healing, with the mean healing period being 6 weeks （range, 5-7w）. According to the scoring system of the American Orthopedic Foot ＆ Ankle Society （AOFAS）, 163 cases were scored excellent, 18 good, and 4 fair, with the excellent and good rate being 97.8%. Conclusions The percutaneous osteotomy through closing puncture in the treatment of moderate and severe hallux valgus has the advantages of less damage, less pain, total correction, and low recurrent rate. Moreover, being simple in operation and low in costs, it can be a good method in the treatment of moderate and severe hallus valgus.
出处
《中国骨肿瘤骨病》
2010年第4期314-316,319,共4页
Chinse Journal Of Bone Tumor And Bone Disease
关键词
拇外翻
微创
内固定术
克氏针
截骨
畸形
Hallux valgus
Minimally invasive
Intemal fixation
Kirschner wire
Osteotomy
Deformity
