可吸收螺钉在拇外翻畸形微创截骨术中的应用分析
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作者Author单位AddressE-Mail
杨勤梦 YANG Qin-meng 广州市正骨医院足踝外科, 广东 广州 510045 Department of Foot and Ankle Surgery, Guangzhou Orthopaedic Hospital, Guangdong 510045, Guangzhou, China  
付小勇 FU Xiao-yong 广州市正骨医院足踝外科, 广东 广州 510045 Department of Foot and Ankle Surgery, Guangzhou Orthopaedic Hospital, Guangdong 510045, Guangzhou, China  
林国杰 LIN Guo-jie 广州市正骨医院足踝外科, 广东 广州 510045 Department of Foot and Ankle Surgery, Guangzhou Orthopaedic Hospital, Guangdong 510045, Guangzhou, China  
洪劲松 HONG Jin-song 广州市正骨医院足踝外科, 广东 广州 510045 Department of Foot and Ankle Surgery, Guangzhou Orthopaedic Hospital, Guangdong 510045, Guangzhou, China zgfoot@163.com 
期刊信息:《中国骨伤》2022年,第35卷,第9期,第836-842页
DOI:10.12200/j.issn.1003-0034.2022.09.007
基金项目:
中文摘要:

目的:探讨可吸收螺钉在拇外翻畸形微创截骨术中的临床疗效。

方法:回顾性分析自2019年1月至2020年1月收治的31例拇外翻患者的临床资料,根据术中使用螺钉不同分为可吸收螺钉组(17例)和钛合金空心螺钉组(14例)。其中可吸收螺钉组男1例,女16例;年龄32~72(54.53±12.12)岁;左侧6例,双侧5例,右侧6例;轻度1例,中度11例,重度5例;采用拇外翻微创截骨术+可吸收螺钉固定进行治疗。钛合金空心螺钉组男2例,女12例;年龄18~71(47.57±15.68)岁;左侧4例,双侧4例,右侧6例;轻度1例,中度9例,重度4例;采用拇外翻微创截骨术+钛合金空心螺钉固定进行治疗。观察两组患者并发症情况,分别于术前和术后12个月在足负重位X线片测量并比较两组患者拇外翻角(hallux valgus angle,HVA)和第1、2跖骨间角(intermetatarsal angle,IMA)变化情况,并比较术前和术后12个月美国足踝外科学会(American Orthopedic Foot and Ankle Society,AOFAS)拇趾关节评分系统和视觉模拟评分(visual analogue scale,VAS)。

结果:31例患者获得随访,时间13~20(16.61±2.47)个月;可吸收钉组随访时间14~20(16.88±2.80)个月,钛合金空心钉组随访时间13~19(16.29±2.05)个月;两组随访时间比较差异无统计学意义(P>0.05)。吸收螺钉组1例出现术口周围出现麻木;钛合金空心钉组3例出现并发症,其中术口周围麻木症状1例,内固定物刺激皮肤症状1例,复发1例;两组并发症比较,差异无统计学意义(χ2=1.651,P=0.199)。两组术前和术后12个月HVA、IMA比较,差异无统计学意义(P>0.05)。两组术前和术后12个月AOFAS评分、VAS比较,差异无统计学意义(P>0.05)。

结论:与拇外翻微创截骨后使用钛合金空心螺钉进行固定相比,使用可吸收螺钉固定在影像学评价和功能评价上可以达到与钛合金空心螺钉固定水平相当的临床效果。
【关键词】拇外翻  可吸收性植入物  最小侵入性外科手术
 
Minimally invasive osteotomy with absorbable screws in treating hallux valgus deformity
ABSTRACT  

Objective: To evaluate clnical effect of minimally invasive osteotomy with absorbable screws in treating hallux valgus deformity.

Methods: Clnical data of 31 patients with hallux valgus deformity were retrospective analyzed from January 2019 to December 2020,and divided into absorbable screws group (17 patients) and titanium cannulated screw group (14 patients).In absorbable screws group,there were 1 male and 16 females aged from 32 to 72 years old with an average of (54.53±12.12) years old;6 patients on the left side,5 on bilateral and 6 on the right side;1 patient was mild,11 moderate and 5 severe;treated with minimally invasive osteotomy and fixation of absorbable screws.In titanium cannulated screw group,there were 2 males and 12 females aged from 18 to 71 years old with an average of (47.57±15.68) years old;4 patients on the left side,4 on bilateral and 6 on the right side;1 patient was mild,9 moderate and 4severe;treated with minimally invasive osteotomy and fixation of titanium cannulated screw.Complications between two groups were observed,changes of hallux valgus angle (HVA) and intermetatarsal angle (IMA) were detected and compared before and after operation at 12 months,American Orthopedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) before and after operation at 12 months were also compared.

Results: All 31 patients were followed up from 13 to 20 months with an average of (16.61±2.47) months.Patients in absorbable screws group were followed up from 14 to 20 months with an average of (16.88±2.80) months,while patients in titanium cannulated screw group were followed up from 13 to 19 months with an average of (16.29±2.05) months;there was no difference between two groups (P>0.05).One patient in absorbable screws group occurred numbness around incision,3 patients in titanium cannulated screw group occurred complications,including numbness around incision in 1 patient,skin irritation due to internal fixation in 1 patient,and recurrence in 1 case;there was no statistic difference between two groups (χ2=1.651,P=0.199).There were no statistic difference in HVA and IMA between two groups before and after operation at 12 months (P>0.05).There were no statistic difference between two groups in AOFAS and VAS before and after operation at 12 months (P>0.05).

Conclusion: Compare with mainstream fixation with titanium hollow screw after minmally invasive osteotomy,fixation with absorbable screw could achieve comparable clinical outcome on the basis of images and function evaluation.
KEY WORDS  Hallux valgus  Absorbable implants  Minimally invasive surgical procedures
 
引用本文,请按以下格式著录参考文献:
中文格式:杨勤梦,付小勇,林国杰,洪劲松.可吸收螺钉在拇外翻畸形微创截骨术中的应用分析[J].中国骨伤,2022,35(9):836~842
英文格式:YANG Qin-meng,FU Xiao-yong,LIN Guo-jie,HONG Jin-song.Minimally invasive osteotomy with absorbable screws in treating hallux valgus deformity[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(9):836~842
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