软组织松解结合跖骨远端截骨治疗跖骨近端关节面固有角增大的轻中度外翻畸形  

Effective analysis on treatment of mild or moderate hallux valgus with distal metatarsal osteotomy and with soft tissue release

作　　者：程明[1] 汤宇[1] 孙天胜[1] 刘智[1] 徐子涵[1] 戴鹤玲[1] 刘志杰[1] 

机构地区：[1]北京军区总医院创伤骨科研究所

出　　处：《中国矫形外科杂志》2013年第13期1302-1306,共5页Orthopedic Journal of China

摘　　要：[目的]探讨软组织松解结合跖骨远端截骨,治疗跖骨近端关节面固有角增大的轻、中度外翻畸形的疗效。[方法]2009年2月～2012年5月本科分别采用软组织松解结合改良Chevron截骨或改良Reverdin截骨术(必要时加用Akin截骨术),治疗以近端关节面固有角增大为特点的外翻患者84例141足。所有患者均按美国足踝外科协会Maryland评分系统中跖趾关节评分标准进行评分。[结果]经过6个月～2年,平均1.5年的随访,随访率69.5%,优77足(78.6%),良21足(21.4%),优良率100%;术后无内翻、切口感染、跖骨头坏死、转移性跖骨痛及骨不连等并发症的发生。[结论]软组织松解结合跖骨远端截骨,治疗跖骨近端关节面固有角增大的轻、中度外翻畸形疗效肯定,患者满意度较高。[ Objective] To investigate the effects of surgical treatment of mild or moderate hallux valgus with distal meta- tarsal osteotomy combined with soft tissue releasing. [Methods] Totally 141 feet （84 patients） with mild or moderate hallux valgus were treated by the modified Chevron osteotomy or modified Reverdin osteotomy combined with Akin osteotomy or soft tis- sue releasing, from February 2009 to May 2012. The function of foot was assessed according to Maryland and plain X - ray films. [ Results] The patient were followed up with average 18 monthes. All distal metatarsal osteotomy healed well. The clinical out- comes were excellent in 77 feet （78.6%） , good in 21 （21.4%） . The overall excellent to good results rate was 100%. No hal- lux varus, wound infection, necrosis of the metatarsal head or nonunion was observed. [ Conclusion] The distal metatarsal os- teotomy combined with soft tissue releasing can be used in the treatment of mild or moderate hallux valgus to obtain satisfactory clinical effect.

关 键 词：外翻 跖骨近端关节面固有角 跖骨远端截骨 

分 类 号：R687.3[医药卫生—骨科学]