| 第1跖骨远端Chevron截骨联合软组织松解术治疗拇外翻 |
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投稿时间：2018-09-25
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| 作者 | Author | 单位 | Address | E-Mail |
| 范东华 |
FAN Dong-hua |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 邢润麟 |
XING Run-lin |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 王培民 |
WANG Pei-min |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 梅伟 |
MEI Wei |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 黄正泉 |
HUANG Zheng-quan |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 张立 |
ZHANG Li |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 丁亮 |
DING Liang |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
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| 茆军 |
MAO Jun |
南京中医药大学附属医院, 江苏 南京 210029 |
The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu, China |
w645660941@163.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第1期，第64-67页 |
| DOI：10.3969/j.issn.1003-0034.2019.01.014 |
| 基金项目: |
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中文摘要:
目的：探讨第1跖骨远端Chevron截骨联合软组织松解术治疗轻、中度拇外翻的临床疗效。
方法：自2015年6月至2017年6月，采用第1跖骨远端Chevron截骨联合软组织松解术治疗拇外翻32例（40足），其中男3例3足，女29例37足；年龄22~80岁，平均57.57岁；病程2~32年，平均14年；轻度9足，中度31足。术前患者合并拇囊炎，伴有第1跖趾关节周围疼痛并存在负重行走时疼痛加重。手术前后拍摄足负重正侧位片，比较拇外翻角（hallux valgus angle，HVA），第1、2跖骨间角（intermetatarsal angle，IMA），并采用美国足踝外科协会拇外翻评分（AOFAS）评价临床疗效。
结果：32例患者获得了随访，时间12~24个月，平均15.2个月。术后切口均愈合良好，无感染、跖骨头坏死等并发症发生。术前HVA、IMA分别由（32.08±5.59）°、（11.63±2.24）°减小至术后12个月的（10.31±4.36）°、（5.02±2.34）°，差异有统计学意义（P<0.05）。AOFAS评分由术前的56.75±6.42提高至术后12个月的88.80±3.99（P<0.05）。
结论：第1跖骨远端Chevron截骨联合软组织松解术治疗轻、中度拇外翻畸形可获得较好的临床效果，为拇外翻治疗提供了更多的选择。 |
| 【关键词】拇外翻 截骨术 跖骨 |
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| Distal Chevron osteotomy of the first metatarsal and soft-tissue release for hallux valgus |
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ABSTRACT
Objective: To explore distal Chevron osteotomy of the first metatarsal and soft-tissue release for the treatment of mild and moderate hallux valgus.
Methods: From June 2015 to June 2017,32 patients(40 feet) with mild and moderate hallux valgus were treated with distal Chevron osteotomy with soft tissue release. including 3 males(3 feet) and 29 females (37 feet),aged from 22 to 80 years old with an average of 57.57 years old. The courses of disease ranged from 2 to 32 years with an average of 14 years. Among them,9 feet were mild,31 feet were moderate. Patients were combined with bunion,pain around the first metatarsal joint,and pain increased during weight-bearing walking before opertaion. AP and lateral X-rays on weight-bearing were performed,hallux valgus angle(HVA) and intermetatarsal angle(IMA) between the first and the second metatarsal were examined before and after operation. AOFAS score was applied to evaluate clinical effects.
Results: All patients were followed up from 12 to 24 months with an average of 15.2 months.Fracture wounds were healed well without infection and metatarsal head necrosis occurred. Preoperative HVA (32.08±5.59)° and IMA (11.63±2.24)° decreased to (10.31±4.36)° and (5.02°±2.34)åfter operation at 12 months,and had statistical difference before and after operation (P<0.05). AOFAS score increased from 56.75±6.42 before operation to 88.80±3.99 after operation at 12 months(P<0.05).
Conclusion: Distal Chevron osteotomy of the first metatarsal and soft-tissue release for the treatment of mild and moderate hallux valgus could obtain good effects and provide more options for hallux valgus treatment. |
| KEY WORDS Hallux valgus Osteotomy Metatarsal Bones |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 范东华,邢润麟,王培民,梅伟,黄正泉,张立,丁亮,茆军.第1跖骨远端Chevron截骨联合软组织松解术治疗拇外翻[J].中国骨伤,2019,32(1):64~67 |
| 英文格式: | FAN Dong-hua,XING Run-lin,WANG Pei-min,MEI Wei,HUANG Zheng-quan,ZHANG Li,DING Liang,MAO Jun.Distal Chevron osteotomy of the first metatarsal and soft-tissue release for hallux valgus[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(1):64~67 |
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