Scarf截骨治疗中重度拇外翻疗效观察  

Therapeutic effects of Scarf osteotomy on moderate and severe hallux valgus

作　　者：王兴龙[1] 马东印[1] 周自广[1] WANG Xinglong;MA Dongyin;ZHOU Ziguang(Department of Orthopedics and Trauma,Pinggu District Hospital,Beijing 101200,China)

机构地区：[1]北京市平谷区医院关节外科-创伤骨科

出　　处：《河北医药》2019年第15期2288-2291,共4页Hebei Medical Journal

摘　　要：目的探讨Scarf截骨用于治疗成人中重度拇外翻中期的疗效。方法回顾北京市平谷区医院41例(48足)采用Scarf截骨治疗的中重度拇外翻患者列为研究对象,测量患者术前、术后的跖拇角(HVA)、第1~2跖骨间夹角(IMA),记录术前、术后疼痛评分(VAS评分)、足部功能评分(AOFAS评分)等指标。结果38例患者得到满意随访,患者失访3例,随访时间6~12个月。患者术前平均HVA角和IMA角分别为(39.5±8.8)°和(14.9±1.7)°,Scarf截骨术后分别减小到(12.2±1.9)°和(6.9±1.1)°,差异有统计学意义(P<0.01)。术前平均VAS评分和AOFAS评分分别为(4.8±1.6)分和(59.7±11.9)分,术后为(1.3±0.9)分和(86.5±6.31)分,差异有统计学意义(P<0.01)。2例患者出现轻度切口浅表感染,经伤口间断换药后愈合,1例患者出现螺钉松动,无其他并发症发生。结论Scarf截骨是矫正中重度拇外翻畸形的一种多平面截骨术,它提供了更大程度的矫形能力和稳定性,有较低的并发症发生率和良好的临床效果,值得推广。Objective To evaluate the therapeutic effects of Scarf osteotomy on moderate and severe hallux valgus.Methods The clinical data about 41 patients(48 feet)with moderate and severe hallux valgus who underwent Scarf osteotomy in our hospital from February 2013 to January 2017 were retrospectively analyzed.The hallux metatarsus angle(HVA),1~2 intermetatarsal angle(IMA)were measured before and after operation,and the preoperative and postoperative pain scores(VAS),foot scores,part function score(AOFAS score)and the other indexes were observed and statistically analyzed.Results Thirty-eight patients were followed up satisfactorily for 6-12 months,however,three patients were lost for follow-up.The preoperative mean HVA angle and IMA angle were(39.5±8.8)°and(14.9±1.7)°,respectively,which were decreased to(12.2±1.9)°and(6.9±1.1)°,respectively after Scarf osteotomy,there were significant differences(P<0.01).Before operation the mean VAS scores and AOFAS scores were(4.8±1.6)points and(59.7±11.9)points,respectively,after operation,which were(1.3±0.9)points and(86.5±6.31)points,respectively,there were significant differences(P<0.01).Two patients occurred mild superficial wound infection and healed after intermittent dressing changes,and one patient occurred screw loosening,however,no other complications were found.Conclusion Scarf osteotomy is a multi-planar osteotomy for correction of moderate and severe hallux valgus deformity,which provides orthopedic ability and stability at even bigger extent and has a lower incidence of complications and good clinical results,therefor,it is worthy of promotion in clinical practice.

关 键 词：拇外翻 截骨术 Scarf截骨术 矫形外科 

分 类 号：R687[医药卫生—骨科学]