踇外翻患者Scarf截骨术对第一跖骨旋转的影响25例报告  

Coronal rotation effect of scarf osteotomy on the first metatarsus in hallux valgus: a report of 25 cases

作　　者：彭建光[1] 王强[1] 李旗[1] PENG Jian-guang;WANG Qiang;LI Qi(Department of Orthopaedics,Xuanwu Hospital,Capital Medical University,Beijing,100053,China)

机构地区：[1]首都医科大学宣武医院骨科,北京100053

出　　处：《中国骨与关节杂志》2018年第12期933-936,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨Scarf截骨术对第1跖骨在冠状面上产生的旋转作用。方法 2016年1～12月,行Scarf截骨术治疗的踇外翻25例(26足)。测量患者术前、术后3个月负重正位X线片上第1跖骨间角(intermetatarsal angle,IMA),踇外翻角(hallux valgus angle,HVA)的值。并在术中测量跖骨旋转的角度(metatarsal rotation angle,MRA),将MRA旋后定义为正值。结果 IMA:术前(14.9±2.8)°,术后(2.4±2.5)°,(P<0.01);HVA:术前(33.9±7.7)°,术后(7.3±5.0)°,(P<0.01);MRA:术中(7.5±3.3)°。MRA和术前、术后的IMA、HVA没有相关性,和手术后IMA、HVA的纠正的角度也没有相关性(P>0.05)。结论 Scarf截骨术主要造成跖骨远端骨块一定程度的旋后,这个内在的改变可能对矫正踇外翻第1跖骨的旋前有一定的作用。Objective To explore the coronal rotation effect of scarf osteotomy on the first metatarsus in hallux valgus. Methods A total of 25 patients (26 feet)who underwent scarf osteotomy for the correction of hallux valgus from Jan 2016 to Dec 2016 were included in this study. The mean age was (58.7±10.1)years (range: 36-78 years). The first intermetatarsal angle (IMA), hallux valgus angle (HVA)on the standing anterior-posterior view were measured before and three months after surgery. Metatarsal rotational angle (MRA)was defined to denote the rotation of the distal fragment, which was measured during the surgery when the scarf osteotomy was completed. Results IMA and HVA were significantly reduced from (14.9±2.8)° and (33.9 ±7.7)° pre-operatively to (2.4±2.5)° and (7.3±5.0)° post-operatively (P<0.01). The mean MRA was (7.5±3.3)° during the operation. MRA was not correlated with pre- and post-operative IMA and HVA, as well as the correction angels of IMA and HVA (P>0.05). Conclusions Scarf osteotomy mainly causes an inherent supination effect on the first metatarsus which may contribute to the correction of pronation component of the hallux valgus.

关 键 词：踇外翻 截骨术 跖骨 矫形外科手术 截骨术 Scarf 

分 类 号：R682.1[医药卫生—骨科学]