| 单纯截骨术矫正第1、2跖骨间角增大型拇外翻的疗效观察 |
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Received:March 23, 2012
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| 作者 | Author | 单位 | Unit | E-Mail |
| 黄涛 |
HUANG Tao |
中国医科大学附属第一医院骨科,辽宁 沈阳 110001 |
Department of Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China |
ht72724@126.com |
| 邹春平 |
ZOU Chun-ping |
中国医科大学附属第一医院骨科,辽宁 沈阳 110001 |
Department of Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China |
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| 李修成 |
LI Xiu-cheng |
中国医科大学附属第一医院骨科,辽宁 沈阳 110001 |
Department of Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China |
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| 冯殿鹏 |
FENG Dian-peng |
中国医科大学附属第一医院骨科,辽宁 沈阳 110001 |
Department of Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China |
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| 杨茂伟 |
YANG Mao-wei |
中国医科大学附属第一医院骨科,辽宁 沈阳 110001 |
Department of Orthopaedics, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning, China |
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| 期刊信息：《中国骨伤》2012年25卷，第12期，第1021-1023页 |
| DOI：10.3969/j.issn.1003-0034.2012.12.012 |
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目的：观察单纯运用截骨矫形术治疗拇外翻的疗效,初步探讨其适用范围和条件。
方法：自2009年12月至2011年4月,采用单纯截骨术治疗第1、2跖骨间角增大型拇外翻20例(32足),男1例(1足),女19例(31足);年龄22～64岁,平均40岁;病程2～31年,平均12年。轻度6足,中度20足,重度6足;术前患者均有第1跖趾关节疼痛且外侧软组织紧张度检查正常;手术前后对足的应力正位X线的拇外翻角(hallux valgus angle,HVA)、第1、2跖骨间角(intermetatarsal angle,IMA)、胫侧籽骨位置进行比较;采用拇外翻疗效评定标准从畸形矫正、拇趾跖趾关节活动度,患者满意度等方面对疗效进行评定。
结果：20例均获随访,时间6～18个月,平均8.5个月;术后切口愈合良好,无感染及跖骨头坏死等并发症,95.1%的患者对疗效感觉非常满意或满意。AOFAS评分由术前(53.1±7.5)分提高到最终随访的(93.1±1.9)分(P<0.05);HVA由术前(33.4±7.8)°纠正到(11.9±3.6)° (P<0.05);IMA由术前(12.3±3.0)°提高到(6.3±1.9)° (P<0.05);胫侧籽骨位置由1.9改善致0.9(P<0.05).
结论：外侧软组织紧张度正常的拇外翻患者其病理变化主要为跖骨内收,仅利用单纯截骨术治疗即可获得满意疗效,无须切断拇收肌。 |
| [关键词]:截骨术 跖骨 拇外翻 矫形外科手术 |
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| Simple osteotomy for correct hallux valgus with increased Ⅰ,Ⅱ intermetatarsal angle |
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Abstract:
Objective:To investigate efficacy of simple osteotomy for correct hallux valgus,and explore its scope and condition.
Methods:From December 2009 to April 2011,20 patients(32 feet) with hallux valgus were treated by simple osteotomy. There were 1 male(1 foot),19 females(31 feet) with an average age of 40 years(ranged,22 to 64 years). The course of disease ranged from 2 to 31 years(mean 12 years). Among them,6 feet were mild,20 feet were moderate,6 feet were serious. Patients had symptoms of metatarsophalangeal joint pain,but tensity of lateral soft tissue were normal. Hallux Valgus Angle(HVA) and Intermetatarsal Angle(IMA) were examined before and after treatment. The criteria of hallux valgus was used to evaluate the effects from valgus deformity,activity of metatarsophalangeal joint,satisfaction of patients.
Results:Twenty patients were followed up from 6 to 18 months with an average of 8.5 months. The wounds were healed well,no infection and metatarsal head necrosis occurred,95.1% of patients were satisfied with the efficacy. Average AOFAS score increased from preoperative(53.1±7.5) points to the final follow-up(93.1±1.9) points (P<0.05),the average correct HVA increased from preoperative(33.4±7.8)°to postoperative (11.9±3.6)° (P<0.05),the average IMA were decreased from preoperative(12.3±3.0)° to postoperative (6.3±1.9)°(P<0.05),tibial sesamoid position improved from 1.9 to 0.9 (P<0.05).
Conclusion:the main pathological changes of hallux valgus patients with normal tension of lateral soft tissue is metatarsal adduction,simple osteotomy can get satisfactory results,no need to cut adductor muscle. |
| KEYWORDS:Osteotomy Metatarsal bones Hallux valgus Orthopedic procedures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄涛,邹春平,李修成,冯殿鹏,杨茂伟.单纯截骨术矫正第1、2跖骨间角增大型拇外翻的疗效观察[J].中国骨伤,2012,25(12):1021~1023 |
| 英文格式: | HUANG Tao,ZOU Chun-ping,LI Xiu-cheng,FENG Dian-peng,YANG Mao-wei.Simple osteotomy for correct hallux valgus with increased Ⅰ,Ⅱ intermetatarsal angle[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(12):1021~1023 |
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