拇外翻术后截骨端稳定性的X线评估法及临床应用  

X-ray evaluation and clinical application of osteotomy stability after hallux valgus surgery

作　　者：毕春强[1,2] 温建民[1] 桑志成[1] 孙卫东 温冠楠 常程[1] 

机构地区：[1]中国中医科学院望京医院骨关节二科,北京100102 [2]中国中医科学院广安门医院南区骨二科,北京102618

出　　处：《中国医药导报》2017年第10期134-137,共4页China Medical Herald

基　　金：国家自然科学基金面上项目(81273984;81373802)

摘　　要：目的采用新的X线评估法评价拇外翻术后截骨端的稳定性。方法回顾性分析2014年11月~2015年3月望京医院采用微创截骨手法整复术治疗的拇外翻患者63例(120足),基于"裹帘"法外固定,于术后即刻、2周、6周、3个月均行统一标准的足负重位X光片检查,采用Image Pro Plus 6.0(IPP 6.0)软件进行点、线定义、完成测定,记录不同时间点角度位移指标(∠α、∠β),位移指标(距离M、距离N值),分析不同时间点角度位移和位移指标的差异。结果术后不同时间点比较,∠α、距离M差异无统计学意义(P>0.05),∠β、距离N值差异有统计学意义(P<0.05),但两两比较,∠β、距离N值差异无统计学意义(P>0.05)。结论新的X线评估法,能直接量化截骨端角度和位移的变化,用于骨折端稳定性的评定,具有准确、可信度高、直接、有效等优点,值得临床应用和推广。Objective To evaluate the osteotomy stability by a new X-ray evaluation method after hallux valgus surgery and put it to clinic using. Methods From November 2014 to March 2015, in Wangjing Hospital of China Academy of Chinese Medical Sciences, the clinical data of 63 hallux valgus patients （120 feet） underwent minimally invasive osteotomy manipulation were retrospectively analyzed, all patients were given postoperatively based on Wrapped Curtain method by ＂8＂ bandage and sub toe pad external fixation and feet weight-bearing X-ray examination in four time points, immediately after the operation, after the operation 2 weeks, 6 weeks, 3 months, then formating files and completing determination for point and lining were used by Image Pro Plus 6 （IPP 6） software, angle displacement index （∠α, ∠β） and displacement index （distance M, N） values were recorded, the difference between the angle and dis- tance at different time points were statistically analysed. Results There was no statistically significant difference in ∠α and distance M values at different time points （P 〉 0.05）, there was statistically significant differences in ∠β and distance N values at different time points （P 〈 0.05）, but two different time points were compared, there was no statistically significant difference in ∠β and distance N values （P 〉 0.05）. Conclusion The new X-ray evaluation method can directly quantify the osteotomy angle and displacement changes and it has advantages of accurate measurement, high reliability, direct and it is worthy of clinical application and promotion.

关 键 词：拇外翻 “裹帘”外固定 截骨端 微动 稳定性 X线评估法 

分 类 号：R687.3[医药卫生—骨科学]