第一跖趾关节融合术对1、2跖骨间夹角改善效果分析  

Effect of the first metatarsophalangeal joint fusion on the angle between the metatarsal and the metatarsal

作　　者：丰波[1] 张澜[1] 李武[1] 张志[1] 王永军[1] 邹英才 王执宇 

机构地区：[1]内蒙古医科大学第三附属医院手足踝外科,包头014010

出　　处：《足踝外科电子杂志》2017年第2期26-30,34,共6页Electronic Journal of Foot and Ankle Surgery

摘　　要：目的分析第一跖趾关节融合术对第1、2跖骨间夹角(IMA)的改善效果。方法选取2012年1月—2016年6月在我院实施第一跖趾关节融合术的患者28例(30足),根据术前IMA大小分为A、B两组,A组IMA11°~15°13足,B组IMA>15°17足。分别于术前、术后拍摄负重X线片,测量并比较IMA角度改善情况。结果本组病例均获随访,随访时间5~26个月,平均12.8个月。所有病例均在术后10~12周获得骨性愈合。A组术前平均IMA 14.38°,术后平均9.77°,平均减小4.62°(P<0.01);B组术前平均IMA 18.41°,术后平均10.65°,平均减小7.76°(P<0.01);总体术前平均IMA 16.67°,术后10.07°,平均IMA减小6.40°(P<0.01)。术前AOFAS评分为(31.25±10.38)分,术后(76.52±10.86)分(P<0.01)。结论第一跖趾关节融合术可有效减小术前增大的IMA角,不必联合第一跖骨近端截骨或融合术;术前IMA越大,术后纠正程度也会相应增大。Objective To analyze the effect of the first metatarsophalangeal joint fusion on the first and second metatarsal angle （IMA）. Methods Twenty-eight patients （30 feet） who underwent first metatarsophalangeal arthrodesis in our hospital from January 2012 to June 2016 were divided into two groups according to the size of preoperative IMA. A, IMA 11° - 15 ° 13 feet, B group IMA〉 15 ° 17 feet. The preoperative and postoperative radiographs were taken to measure and compare the improvement of IMA angles. Results The patients were followed up for 5 ~ 26 months with an average of 12.8 months. All cases received bony union 10 to 12 weeks after operation. In group A, the average preoperative IMA was 14.38 ° and the average postoperative was 9.77 °, with an average reduction of 4.62 ° （P〈0.01）. The preoperative average IMA 18.41 ° in group B and the average postoperative average of 10.65 ° were 7.76 ° （P〈0.01））. The overall preoperative average IMA 16.67° , postoperative 10.07° , the average IMA decreased 6.40°（P〈0.01）. Preoperative AOFAS score was （31.25 ± 10.38） points, postoperative （76.52 ± 10.86） points （P〈0.01）. Conclusion The first metatarsophalangeal arthrodesis can effectively reduce the preoperative IMA angle without the need of the first proximal metatarsal osteotomy or fusion. The larger the preoperative IMA, the more the postoperative correction will be.

关 键 词：第一跖趾关节融合术 第1 、2跖骨间夹角 

分 类 号：R687.4[医药卫生—骨科学]