摘要
目的:观察外翻截骨矫形"裹帘"法外固定后截骨端的稳定性。方法:回顾性分析2014年11月至2015年3月在望京医院就诊的63例(120足)外翻患者的病例资料。均采用中西医结合微创技术截骨矫形,术后采用基于"裹帘"法理念设计的"8"字绷带和分趾垫外固定。在其术后即刻、2周、6周、12周拍摄的患足负重正侧位X线片上测量截骨端的角度变化(α、β)和位移(M、N),同时观察截骨端愈合情况。结果:本组患者患足趾固定后不同时间点的角α及距离M比较,差异均无统计学意义[(7.30°±1.57°),(7.25°±1.62°),(7.38°±1.66°),(7.32°±1.43°),F=1.005,P=0.390;(10.51±2.22)mm,(10.62±2.15)mm,(10.49±2.93)mm,(10.56±2.08)mm,F=0.389,P=0.761];不同时间点间的角β及距离N比较,差异均有统计学意义[(13.00°±3.97°),(12.80°±3.85°),(12.63°±3.85°),(12.67°±4.03°),F=2.958,P=0.032;(10.93±1.44)mm,(10.79±1.63)mm,(10.73±1.62)mm,(10.63±1.49)mm,F=2.685,P=0.047];角β及距离N于不同时间点间两两比较,差异均无统计学意义。术后12周时所有截骨端均达到骨折临床愈合标准。结论:外翻截骨矫形术后以基于"裹帘"法理念设计的"8"字绷带和分趾垫外固定,可以维持截骨端相对稳定。
Objective： To observe the stability of osteotomy site after osteotomy and external fixation based on concept of＂wrapped curtain＂for treatment of hallux valgus. Methods： The medical records of 63 patients（ 120 feet） with hallux valgus who were treated in Wangjing Hospital from November 2014 to March 2015 were analyzed retrospectively. The patients were treated with minimally invasive osteotomy under the guidance of integrated Chinese and Western medicines theory and postoperative external fixation with figure-of-eight bandages and digital pads based on the design concept of＂wrapped curtain＂. The angles（ α,β） and displacement（ M,N） of osteotomy sites of the affected feet were measured on weight-bearing anteroposterior and lateral x-ray films taken immediately post-operatively and at 2,6 and 12 weeks after the surgery respectively. Meanwhile the healing of osteotomy sites were observed. Results： There was no statistical difference in the angleα and distance M between different time points after fixation of hallux of affected feet（ 7. 30 ＋/- 1. 57,7. 25 ＋/- 1. 62,7. 38 ＋/- 1. 66,7. 32 ＋ /- 1. 43 degrees,F = 1. 005,P = 0. 390; 10. 51 ＋ /- 2. 22,10. 62 ＋ /- 2. 15,10. 49 ＋ /- 2. 93,10. 56 ＋ /- 2. 08 mm,F = 0. 389,P =0. 761）. There was statistical difference in the angle β and distance N between different time points（ 13. 00 ＋ /- 3. 97,12. 80 ＋ /- 3. 85,12. 63 ＋ /- 3. 85,12. 67 ＋ /- 4. 03 degrees,F = 2. 958,P = 0. 032; 10. 93 ＋ /- 1. 44,10. 79 ＋ /- 1. 63,10. 73 ＋ /- 1. 62,10. 63 ＋ /- 1. 49 mm,F = 2. 685,P = 0. 047）. There was no statistical difference in the angle β and distance N between the paired time points. All of the osteotomy sites got clinical healing at the 12 weeks after the surgery. Conclusion： The relative stabilization of osteotomy sites can be obtained through external fixation with figure-of-eight bandages and digital pads based on the design concept of＂wrapped curtain＂after osteotomy for treatment of hallux valgus.
出处
《中医正骨》
2016年第3期5-8,共4页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
国家自然科学基金项目(81273984)
关键词
踇外翻
骨折固定术
截骨术
绷带
稳定性
hallux valgus
fracture fixation
osteotomy
bandages
stability
