跖骨近端Z形截骨短缩手术治疗成人症状性Morton趾  

Shortening of the proximal end of metatarsal in the treatment of symptomatic Morton's Toe

作　　者：解冰[1] 张昊[1] 杨超[1] 薛海鹏[1] 周大鹏[1] 田竞[1] XIE Bing ZHANG Hao YANG Chao XUE Haipeng ZHOU Dapeng TIAN Jing(Department of Orthopedics, Shenyang Military Region General Hospital, Shenyang 110016, China)

机构地区：[1]沈阳军区总医院骨科,沈阳110016

出　　处：《中国骨与关节外科》2016年第4期276-279,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景：临床上症状性Morton趾较为少见,目前国内外鲜有关于其手术治疗方面的报道。目的：采用跖骨近端Z形截骨短缩手术治疗症状性Morton趾,并评价其初期疗效。方法：2014年1月至2014年12月,对6例（10足）Morton趾患者实施相对较长跖骨的近端Z形截骨短缩手术,评价患足手术前后影像学改变及美国足踝外科协会（AOFAS）评分差异。结果：患者均获得9-21个月,平均（15.0±4.6）个月随访。截骨部位均获得骨性愈合,愈合时间10-14周,平均（11.6±2.7）周。术前第1、2跖骨相对长度差为11.5-15.5 mm,平均（14.3±2.7）mm,术后为2.0-6.0 mm,平均（3.9±1.2）mm,有统计学差异（P〈0.05）。第2跖骨短缩8.0-13.5 mm,平均（10.1±3.3）mm,约占第2跖骨长度的16.4%。而AOFAS评分由术前的48-64分,平均（57.3±6.0）分提高到术后的74-87分,平均（81.0±5.6）分,有统计学差异（P〈0.05）。结论：对于症状性Morton趾,对相对较长的跖骨采用跖骨近端Z形截骨短缩手术可以有效纠正畸形、恢复正常的跖骨头相对长度,患足疼痛及外观改善明显,但远期疗效仍需进一步观察。Background：Symptomatic Morton＇s toe is a rare disease in clinic,and so far,there are few reports about its surgical treatment.Objective：To assess the preliminary clinical outcome of shortening of the proximal end of metatarsal in patients with symptomatic Morton＇s toe.Methods：From January 2014 to December 2014,a total of 10 feet in 6 adult patients with symptomatic Morton＇s toe underwent shortening of the proximal end of metatarsal.The radiological measurement and the American Orthopedic Foot and Ankle Society（AOFAS） score were used for the evaluation of difference between preoperation and postoperation.Results：Average duration of follow-up was（15.0±4.6） months（range,9-21 months）.All patients achieved primary bone union,and the average bone healing time was（11.6±2.7） weeks（range,10-14 weeks）.The relative length difference between 1-（st） and 2-（nd） metatarsal decreased significantly from（14.3±3.7） mm preoperatively（range,11.5-15.5 mm） to（3.9±1.2） mm postoperatively（range,2.0-6.0mm,P〈0.05）.The length of 2-（nd） metatarsal decreased by（10.1±3.3） mm,about 16.4%compared with preoperative one.The mean postoperative AOFAS score was significantly higher than preoperative one（81.0±5.6 vs 57.3±6.0,P〈0.05）.Conclusions：For symptomatic Morton＇s toe,surgical correction by shortening of the proximal end of metatarsal can effectively correct abnormality of foot,obviously improve foot appearance and relieve the pain.But the long-term curative effect still needs further observation.

关 键 词：Morton趾 截骨 先天畸形 

分 类 号：R687.31[医药卫生—骨科学]