Ludloff截骨与Juvara截骨对单纯重度外翻的疗效对比  

Compare the clinical outcome between Ludloff osteotomy and Juvara osteotomy in simple severe hallux valgus

作　　者：刘锌[1] 杜斌[2] 孙光权[1] 朱旭日 陈国庆[1] 杨建伟[1] 林清宇[1] 

机构地区：[1]南京中医药大学,南京210023 [2]江苏省中医院骨伤科

出　　处：《南通大学学报（医学版）》2016年第3期189-192,共4页Journal of Nantong University(Medical sciences)

摘　　要：目的:比较Ludloff截骨与Juvara截骨对单纯严重外翻的疗效。方法 :跖间角(inter metatarsal angle,IMA)>16°的严重单纯外翻患者19例22足,随机分为Ludloff截骨组(10例11足)与Juvara(9例11足)截骨组,两组患者性别、年龄、IMA、外翻角(hallux valgus angle,HVA)、近端关节面固有角(proximal articular set angle,PASA)、远端关节面固有角(distal articular set angle,DASA)、第一跖骨长度、胫侧籽骨位置、疼痛视觉模拟评分(visual analogue scale,VAS)差异无统计学意义。术前与术后1、3、6、12个月分别摄足部正侧位片并做美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分及VAS评分评估两组外翻矫形术的疗效。结果 :两组AOFAS评分、胫侧籽骨位置及平均手术时间比较,差异均无统计学意义(P>0.05)。与Juvara手术组比较,Ludloff手术组术后第一跖骨疼痛发生率、第一跖骨长度短缩程度及VAS评分均较低(P<0.05)。两组术后影像学检查显示IMA、HVA等差异无统计学意义(P>0.05)。结论:Ludloff截骨组与Juvara截骨治疗单纯严重外翻均有较好的疗效且疗效相近,Ludloff术后第一跖骨短缩发生率更低,患者满意度更高。Objective： To compare the cli nical outcome between Ludloff osteotomy and Juvara osteotomy in simple severe hallux valgus. Methods： 19 patients（22 feet） with inter metatarsal angle（IMA） 16° were randomly divided into two groups：Ludloff osteotomy group（10 patients,11 feet） and Juvara osteotomy group（9 patients,11 feet）. The sex, age, IMA, hallux valgus angle（HVA）, proximal articular set angle（PASA）, distal articular set angle（DASA）, length of first metatarsal bone, location of tibial sesamoid bone and visual analogue scale（VAS） score of two groups were similar. Take the X-ray postoperative（1, 3, 6,12 months） and the curative effects were evaluated according to American Orthopaedic Foot and Ankle Society（AFOAS）scoring system as well as the VAS scoring system. Results： The AFOAS score, the location of tibial sesamoid bone and the average operation time were no statistically significant differences（ P〉0.05）. Compared with the Juvara osteotomy group, the Ludloff osteotomy group had lower incidence of pain and shortening of first metatarsal bone, otherwise, had a lower VAS score（P〈0.05）, but the IMA and HVA had no statistically significant differences（P〉0.05）. Conclusions： Both Ludloff osteotomy and Juvara osteotomy were reliable in treating simple severe hallux valgus and the clinical results had no statistically significant differences. The Ludloff osteotomy had lower incidence of pain and shortening of first metatarsal bone, so the patients was more satisfied.

关 键 词：外翻 Ludloff截骨 Juvara截骨 

分 类 号：R682.16[医药卫生—骨科学]