摘要
[目的]评价3D打印导板辅助经皮微创跖骨横行截骨(percutaneous minimally invasive metatarsal transverse osteotomy,PMIMTO)治疗轻中度[足母]外翻的疗效。[方法]回顾性分析2022年6月-2023年4月采用3D打印导板辅助PMIMTO治疗的21例轻中度[足母]外翻患者的临床资料。采用美国矫形足踝外科学会(American Orthopedic Foot and Ankle Society, AOFAS)前足评分、视觉模拟评分(visual analogue scale, VAS)对患者的疗效和功能进行评价。行影像检查,测量[足母]外翻角(hallux valgus angle, HVA)、第1、2跖骨间角(intermetatarsal angle, IMA),记录手术时长和第1跖骨短缩程度。[结果]所有患者手术顺利,伤口均Ⅰ期愈合,未出现并发症。平均随访时间(15.1±2.2)个月。随术前、术后3个月和末次随访的时间推移,AOFAS前足评分[(59.7±3.6),(86.7±1.6),(89.8±4.3), P<0.001]和疼痛VAS评分[(6.1±1.3),(2.1±0.7),(0.7±0.6), P<0.001]显著改善。至末次随访时,所有患者均未出现跖骨头坏死、骨不连、畸形复发等并发症。影像方面,与术前相比,术后3个月和末次随访时HVA[(32.2±5.0)°,(11.9±1.1)°,(11.2±2.6)°, P<0.001]和IMA[(12.6±1.6)°,(9.0±0.6)°,(8.1±1.4)°, P<0.001]均显著改善。[结论] 3D打印置钉导板可以有效提高PMIMTO的安全性与有效性,缩短手术时间,是一种安全、有效的方法。
[Objective]To evaluate the clinical efficacy of 3D-printed guide-assisted percutaneous minimally invasive metatarsal transverse osteotomy(PMIMTO)in the treatment of mild to moderate hallux valgus deformity.[Methods]A retrospective research was conducted on 21 patients(22 feet)who received the 3D-printed guide-assisted PMIMTO for mild to moderate hallux valgus deformity between June 2022 and April 2023.The therapeutic consequence and function of the patients were evaluated by using the forefoot score of the American Orthopaedic Foot and Ankle Society(AOFAS)and the visual analogue scale(VAS)for pain.As imaging taken,the hallux valgus angle(HVA)and the intermetatarsal angle(IMA)between the first and second metatarsals were measured,as well as the extents of the first metatarsal shortened were recorded.[Results]All the patinets had PMIMTO performed smoothly,with wounds healed in the first stage and no complications.The average follow-up time was of(15.1±2.2)months.With time elapsed preoperatively,3 months postoperatively and the the last follow-up,AOFAS forefoot score[(59.7±3.6),(86.7±1.6),(89.8±4.3),P<0.001]and pain VAS score[(6.1±1.3),(2.1±0.7),(0.7±0.6),P<0.001]were significantly improved.At the last follow-up,no complications such as metatarsal head necrosis,nonunion of bones,or recurrence of deformity occurred in anyone of the patients.In terms of imaging,the HVA[(32.2±5.0)°,(11.9±1.1)°,(11.2±2.6)°,P<0.001]and IMA[(12.6±1.6)°,(9.0±0.6)°,(8.1±1.4)°,P<0.001]were significantly improved 3 months postoperatively and at the latest follow-up compared with those before the operation.[Conclusion]This 3D-printed guide does effectively improve the safety and effectiveness of PMIM-TO and shorten the operation time,is a safe and effective method.
作者
王嘉正
张解元
杨建义
郭英
李广翼
李学谦
王诚
吴承霖
张书滔
梅国华
马昕
施忠民
WANG Jia-zheng;ZHANG Jie-yuan;YANG Jian-yi;GUO Ying;LI Guang-yi;LI Xue-qian;WANG Cheng;WU Cheng-lin;ZHANG Shu-tao;MEI Guo-hua;MA Xin;SHI Zhong-min(Department of Orthopedics,Foot and Ankle Surgery,The Sixth People's Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200233,China;Guandu District People's Hospital of Kunming City,Kunming 650220,Yunnan,China;The Third Affiliated Hospital,Yunnan University of Traditional Chinese Medicine,Kunming 650051,Yunnan,China)
出处
《中国矫形外科杂志》
北大核心
2025年第15期1431-1434,1437,共5页
Orthopedic Journal of China
基金
上海市科学技术委员会科技计划项目(编号:23015820500)
上海市创新医疗器械应用示范项目(编号:23SHS03600)。
关键词
[足母]外翻
[足母]囊炎
经皮微创跖骨横行截骨
3D打印导板
微创手术
hallux valgus defomity
hallux bunion
percutaneous minimally invasive transverse metatarsal osteotomy
3D printed guide
minimally invasive surgery
