拇外翻畸形两种拇收肌腱止点重建方法的比较  

A comparison of different adductor tendon transpositions for correction of hallux valgus

作　　者：魏宝富[1] 裴国献[1] 王丹[1] 孙永建[1] 

机构地区：[1]南方医科大学南方医院创伤骨科,广州510515

出　　处：《山东大学学报（医学版）》2010年第3期141-143,共3页Journal of Shandong University:Health Sciences

摘　　要：目的比较两种拇内收肌腱止点重建方法的疗效。方法回顾分析改良McBride手术矫正轻、中度拇外翻27例36足,拇内收肌腱缝合于第一跖骨头外侧关节囊组(A组)14例19足,经骨孔缝合于内侧关节囊组(B组)13例17足。结果A组:拇外翻角、第1、2跖骨间夹角分别改善(14.9±3.7)°、(4.2±1.2)°,第一跖趾关节功能评分提高45±5;B组:拇外翻角、第1、2跖骨间夹角分别改善(18.1±4.3)°、(6.4±2.6)°,第一跖趾关节功能评分提高48±6。两组比较拇外翻角、第1、2跖骨间夹角差异有统计学意义(P<0.05);第一跖趾关节功能评分差异无统计学意义(P>0.05)。结论两种方法重建拇内收肌腱止点治疗轻中度拇外翻畸形临床疗效相近,但是经骨孔与内侧关节囊缝合法矫正拇外翻角、第1、2跖骨间夹角优于外侧关节囊缝合法。Objective To compare the effect of different adductor tendon transpositions for correction of hallux valgus.Methods The data of 27 patients（36 feet）,who were operated with modified McBride procedure between 2004 and 2006 were retrospectively analyzed.The adductor tendon was sutured to the lateral capsule（group A） in 14 cases（19 feet）,or sutured to the medial capsule through a bone hole（group B） in 13 cases（17 feet）.The follow-up period was 30 to 36 months.The hallux valgus angle（HVA）,the 1st-2nd intermetatarsal angle（IMA） and the American Orthopaedic Footand Ankle Score（AOFAS）pre-and postoperatively in each group were recorded.Results In group A the improvement of HVA,IMA and AOFAS were（14.9±3.7）°,（4.2±1.2）° and 45±5 respectively,in group B they were（18.1±4.3）°,（6.4±2.6）°and 48±6 respectively.The statistical difference was significant in HVA and IMA,but there was no statistical difference in AOFAS.Conclusion Clinical satisfaction was similar in the two groups.The effect of the adductor tendon sutured to the medial capsule through a bone hole was better than that in correction of HVA and IMA.

关 键 词：拇外翻 拇内收肌 改良McBride手术 

分 类 号：R682.6[医药卫生—骨科学]