| 两种截骨术式治疗中重度拇外翻影像学效果与临床疗效的系统评价 |
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投稿时间：2018-11-02
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| 作者 | Author | 单位 | Address | E-Mail |
| 邓伟 |
DENG Wei |
成都上锦南府医院 四川大学华西医院上锦医院骨科, 四川 成都 611731
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 陈宇 |
CHEN Yu |
成都上锦南府医院 四川大学华西医院上锦医院骨科, 四川 成都 611731
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 李亚星 |
LI Ya-xing |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 吴仕舟 |
WU Shi-zhou |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 任毅 |
REN Yi |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 黄富国 |
HUANG Fu-guo |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
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| 张晖 |
ZHANG Hui |
四川大学华西医院骨科, 四川 成都 610041 |
Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China |
caesarzh@163.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第8期，第765-771页 |
| DOI：10.3969/j.issn.1003-0034.2019.08.018 |
| 基金项目: |
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中文摘要:
目的：系统评价Chevron截骨术与Scarf截骨术治疗中重度拇外翻的影像学效果和临床疗效。
方法：计算机检索PubMed、Embase、Cochrane Library、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、万方期刊全文数据库（Wanfang Data）关于Chevron截骨术与Scarf截骨术治疗拇外翻的随机对照研究（RCT），检索时限从建库至2018年6月。由2名研究者独立按照纳入和排除标准筛选文献，评价纳入文献的偏倚风险和提取相关观察指标后，采用RevMan 5.3.5软件进行Meta分析。比较两种截骨术式术后拇外翻角（HVA）、1-2跖骨间角（IMA）、跖骨远端关节面固有角（DMAA）、美国骨科足踝外科协会评分（AOFAS）、术后切口并发症以及患者满意度。
结果：最终纳入6篇随机对照研究文献，共507例（足）患者，92.5%的患者为中重度拇外翻，其中Chevron截骨术261例（足），Scarf截骨术246例（足）。Meta分析结果显示：Chevron截骨术在矫正HVA方面优于Scarf截骨术[MD=-1.95，95% CI （-2.64，-1.27），P<0.000 01]。而两种方法在IMA[MD=-0.42，95% CI （-1.04，0.21），P=0.19]，DMAA[MD=0.78，95% CI （-0.72，2.29），P=0.31]，AOFAS评分[MD=2.47，95% CI （-2.38，7.33），P=0.32]，术后切口并发症[RR=1.09，95% CI （0.54，2.20），P=0.82]，患者满意度[RR=1.00，95% CI （0.96，1.05），P=0.92]方面比较差异无统计学意义。
结论：Chevron截骨术操作简单、跖骨短缩少、创伤小，在治疗中重度拇外翻矫正HVA方面优于Scarf截骨术，在IMA、DMAA、AOFAS评分、并发症、患者满意度方面二者效果相似。 |
| 【关键词】拇外翻 截骨术 Meta分析 |
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| Chevron osteotomy versus Scarf osteotomy for the efficacy of radiographic and clinical in moderate and severe hallux valgus: a systematic review |
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ABSTRACT
Objective:To evaluate efficacy of radiographic and clinical of Chevron osteotomy versus Scarf osteotomy for hallux valgus at moderate and severe degree.
Methods:Randomized controlled trial (RCT) about Chevron and Scarf osteotomy for hallux valgus,in PubMed,Embase,Cochrane Library,CBM,CNKI,Wanfang Data were searched by computer from establishing database to June 2018. According to inclusion and exclusion criteria,two researchers independently screened the literatures,evaluated risk of bias and extracted related observation index,RevMan 5.3.5 software was used to perform Meta-analysis. Postoperative hallux valgus angle (HVA),intermetatarsal angle (IMA),distal metatarsal articular angle (DMAA),AOFAS score,complications and patients' satisfaction degree between Chevron and Scarf osteotomy.
Results:Six RCT literatures were included,involving 507 patients,92.5% patients were at moderate and severe degree,and 261 patients were performed by Chevron osteotomy and 246 patients were performed by Scarf osteotomy. Meta analysis results showed that Chevron osteotomy was better than Scarf osteotomy in correcting HVA[MD=-1.95,95%CI(-2.64,-1.27),P<0.000 01]. While there were no statistical differences in IMA[MD=-0.42,95%CI(-1.04,0.21),P=0.19],DMAA[MD=0.78,95%CI(-0.72,2.29),P=0.31],AOFAS score[MD=2.47,95%CI(-2.38,7.33),P=0.32],complications[RR=1.09,95%CI(0.54,2.20),P=0.82],and patients' satisfaction degree[RR=1.00,95%CI(0.96,1.05),P=0.92].
Conclusion:Chevron osteotomy,which has advantages in simple operation,shorten metatarsal bone,less trauma,was better in correcting HVA of hallux valgus at moderate and severe degree,and had similar effects in IMA,DMAA,AOFAS score,complications and patients' satisfactory degree. |
| KEY WORDS Hallux valgus Osteotomy Meta-analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邓伟,陈宇,李亚星,吴仕舟,任毅,黄富国,张晖.两种截骨术式治疗中重度拇外翻影像学效果与临床疗效的系统评价[J].中国骨伤,2019,32(8):765~771 |
| 英文格式: | DENG Wei,CHEN Yu,LI Ya-xing,WU Shi-zhou,REN Yi,HUANG Fu-guo,ZHANG Hui.Chevron osteotomy versus Scarf osteotomy for the efficacy of radiographic and clinical in moderate and severe hallux valgus: a systematic review[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(8):765~771 |
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