摘要
第1跖趾关节融合术为临床严重[足母]外翻常用矫形术式,具有悠久历史且沿用至今。手术适应证包括严重[足母]外翻畸形、复发[足母]外翻畸形翻修、类风湿性关节炎[足母]趾畸形、严重[足母]僵硬、关节感染、原发性或继发性骨关节炎、神经肌肉病变导致的[足母]外翻畸形、严重痛风性关节炎等第1跖趾关节病变导致的畸形。与第1跖趾关节融合手术相关的生物力学和材料学等方面研究不断有创新结果出现,使手术内固定物选择多样且得到不断进展,从传统的螺钉、钢板发展至新颖的髓内固定系统和记忆金属内植物等。生物力学、步态分析以及临床研究均表明,该术式对患者步态影响小,对运动能力无明显影响,手术操作得当则并发症少,是治疗严重[足母]外翻畸形的有效、可靠方法。
First metatarsophalangeal joint arthrodesis,as a corrective measure for severe hallux valgus deformity,has a long history and remains in use today.Indications for the first metatarsophalangeal joint arthrodesis include severe hallux valgus deformity,recurrent hallux valgus,hallux deformity in rheumatoid arthritis,severe hallux rigidus,joint infection,primary or secondary osteoarthritis,hallux valgus deformity due to neuromuscular disorders,and severe gouty arthritis.Innovative research continues to emerge in biomechanics and materials science related to the first metatarsophalangeal joint arthrodesis.Surgical fixation options are diverse and evolving,encompassing traditional screws and plates alongside novel intramedullary fixation systems and shape-memory alloy implants.Biomechanical studies,gait analysis research,and clinical trials consistently demonstrate minimal postoperative impact on gait and no significant impairment of functional mobility.When performed with proper technique,complications are rare.The first metatarsophalangeal joint arthrodesis is an effective and reliable method for treating severe hallux valgus deformity.
作者
朱渊
徐向阳
ZHU Yuan;XU Xiangyang(Department of Orthopedics,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200025,P.R.China)
出处
《中国修复重建外科杂志》
北大核心
2025年第10期1232-1239,共8页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
第1跖趾关节
关节融合
[足母]外翻
手术治疗
First metatarsophalangeal joint
arthrodesis
hallux valgus
surgical treatment
