踇外翻SCARF截骨矫正术对患侧膝骨性关节炎进展的影响  

Effect of SCARF Osteotomy Operation of Hallux Valgus on the Stage of Knee Osteoarthritis Patients in the Lesion Side

作　　者：张伟强[1] 李具宝[1] 李帆冰[1] 李鹏飞[1] 

机构地区：[1]云南省中医医院骨伤科,云南昆明650021

出　　处：《昆明医科大学学报》2017年第9期100-104,共5页Journal of Kunming Medical University

基　　金：云南省自然科学基金资助项目(2011FZ266)

摘　　要：目的探究踇外翻SCARF或反向SCARF截骨矫正术后对患者膝关节骨性关节炎疾病进展的影响.方法采用回顾性分析将2012年3月至2014年3月在云南省中医医院骨科住院诊断为中、重度踇外翻并伴有患侧膝关节骨性关节炎资料完整的45例患者纳入研究.将22例SCARF或反向SCARF截骨患者纳入手术组,而将23例保守治疗患者纳入非手术组.对治疗前后2组间患者踇外翻足部畸形常规角度测量比较采用t检验.对住院治疗前后2组间患者同侧膝关节骨性关节炎分期采用χ~2检验进行分析.结果 2~3 a后随访:(1)与非手术组患者相比手术组患者踇外翻足部畸形各项常规角度测量值明显改善,差异有显著统计学意义(P<0.01);(2)与非手术组患者相比手术组患者患侧膝关节骨性关节炎进展速度明显降低,治疗前后分期关联明显,有显著统计学意义(P<0.01);(3)与手术组患者相比非手术组患者患侧膝关节骨性关节炎进展速度明显加快,治疗前后分期无关联,无统计学意义(P>0.05);(4)经χ~2检验治疗后2组患者膝骨性关节炎分期构成比明显不同,有显著统计学意义(P<0.01).结论对伴有患侧踇外翻的膝关节骨性关节炎患者来说应当积极采用SCARF(或反向SCARF)截骨术治疗踇外翻,不仅可以治疗踇外翻的局部症状,而且可以减慢患侧膝关节骨性关节炎的病理进展速度.Objective To investigate the effect of SCARF or reverse SCARF osteotomy operation of HalluxValgus on the stage of knee osteoarthritis patients in the lesion side. Methods Retrospective analysis was used torecruit the 45 patients who were diagnosed as moderate or severe Hallux Valgus accompanying Knee osteoarthritis onthe lesion side and had complete data. We divided the 22 cases who received the SCARF （or reverse SCARF ）osteotomy operation into operation group and divided the 23 cases who received the no-operation treatments intono-operation group. T test was used to compare the difference of Hallux Valgus common malformation angles betweenof two groups before and after the resident treatment. χ2test was used to compare the difference between two groupson stages of knee osteoarthritis before and after the resident treatment. Results Follow-up for 2-3 yearsr： （1）Compared with the no-operation group,the amelioration of Hallux Valgus common malformation angles measured ofoperation patient group, the difference had statistical significance（ 〈0.01） . （2） Compared with theno-operation group the accelerating speed of knee osteoarthritis in the lesion side of operation patient group wasdelayed, the relation of staging before and after the treatment had significant difference（ 〈0.01） . （3）Compared with the operation group,the accelerating speed of knee osteoarthritis in the lesion side of operation patient group was increased without the relation of staging before and after the treatment and had no significantdifference（ 〉0.05）. （ 4） After the treatment,the constitution rate difference of Knee Osteoarthritis between thetwo groups had statistical significance （ 〈0.01） . Conclusion For the patients who suffered from Hallux Valgusand Knee Osteoarthritis in the lesion side,active applying the SCARF or reverse SCARF osteotomy operation ofHallux Valgus may not only cure the local symptoms of Hallux Valgus but also delay the pathological acceleratingspeed of Knee Osteoarthritis in t

关 键 词：踇外翻 膝关节骨性关节炎 SCARF或反向SCARF截骨手术 

分 类 号：R68[医药卫生—骨科学]