摘要
目的探讨第1跖列三平面截骨联合其余跖骨基底截骨治疗中重度跖内收型[足母]外翻的早期疗效。方法2012年2月-2016年9月,收治10例(12足)中重度跖内收型[足母]外翻患者。男1例(2足),女9例(10足);年龄21~55岁,平均34.5岁。病程3~10年,平均5.8年。根据改良Sgarlato测量法对跖内收分度:中度4足、重度8足。术前美国矫形足踝协会(AOFAS)评分为(46.4±9.3)分;跖内收角(metatarsus adductus angle,MAA)为(25.41±3.66)°,[足母]外翻角(hallux valgus angle,HVA)为(41.42±9.67)°,第1-2跖骨间角(first-second intermetatarsal angle,1-2IMA)为(10.72±2.26)°。采用第1跖列三平面截骨联合其余跖骨基底截骨以及外侧软组织松解术治疗。结果术后切口均Ⅰ期愈合。患者均获随访,随访时间18~24个月,平均21.4个月。1例(1足)术后出现转移性跖痛,对症处理后症状消失。X线片复查示截骨部位均愈合,愈合时间为2.4~3.2个月,平均2.8个月。末次随访时,MAA为(8.42±0.71)°、HVA为(13.29±1.03)°、1-2IMA为(4.41±0.48)°,AOFAS评分为(89.8±5.9)分,均较术前明显改善(P<0.05)。结论第1跖列三平面截骨联合其余跖骨基底截骨治疗中重度跖内收型[足母]外翻,可获得较好早期疗效。
Objective To evaluate the short-term effectiveness of the first ray tri-plane osteotomy and other metatarsal basal osteotomy in treatment of hallux valgus with moderate and severe metatarsus adductus.Methods Between February 2012 and September 2016, 10 patients(12 feet) of hallux valgus with moderate and severe metatarsus adductus were admitted and treated with the first ray tri-plane osteotomy and other metatarsal basal osteotomy and lateral soft tissue release. There were 1 male(2 feet) and 9 females(10 feet) with an average age of 34.5 years(range,21-55 years). The disease duration ranged from 3 to 10 years(mean, 5.8 years). The degree of metatarsal adductus was moderate in 4 feet and severe in 8 feet according to modified Sgarlato measurement method. Preoperative American Orthopaedic Foot and Ankle Society(AOFAS) score was 46.4±9.3. The metatarsus adductus angle(MAA) was(25.41±3.66)°, hallux valgus angle(HVA) was(41.42±9.67)°, and the first-second intermetatarsal angle(1-2 IMA) was(10.72±2.26)°. Results All incisions healed by first intention. All patients were followed up 18-24 months, with an average of 21.4 months. One patient(1 foot) had metastatic metatarsalgia after operation, but the symptoms disappeared after symptomatic treatment. X-ray re-examination showed that all osteotomies healed, and the healing time was 2.4-3.2 months, with an average of 2.8 months. At last follow-up, MAA was(8.42±0.71)°, HVA was(13.29±1.03)°, 1-2 IMA was(4.41±0.48)°, and AOFAS score was 89.8±5.9. There were significant differences in clinical and radiographic indexes between pre-and post-operation(P<0.05). Conclusion The first ray tri-plane osteotomy combined with other metatarsal basal osteotomy has a significant short-term effectiveness in the treatment of hallux valgus with moderate and severe metatarsus adductus.
作者
常鑫
张云龙
杨杰
李毅
张言
温晓东
梁晓军
CHANG Xin;ZHANG Yunlong;YANG Jie;LI Yi;ZHANG Yan;WEN Xiaodong;LIANG Xiaojun(Xi’an Medical University,Xi’an Shaanxi,710068,P.R.China;Department of Foot and Ankle Surgery,Honghui Hospital Affiliated to Medical School of Xi’an Jiaotong University,Xi’an Shaanxi,710054,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2020年第1期37-40,共4页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
跖内收
[足母]外翻
三平面截骨
跖骨基底截骨
Metatarsus adductus
hallux valgus
tri-plane osteotomy
metatarsal basal osteotomy
