第1跖趾关节融合术联合跖趾关节成形术治疗老年拇外翻  

The first metatarsophalangeal joint fusion combined with metatarsophalangeal joint arthroplasty in the treatment of hallux valgus in the elderly

作　　者：刘卫刚 马亮[1] 张子景 宋仕宝 许永涛[1] LIU Wei-gang;MA Liang;ZHANG Zi-jing;SONG Shi-bao;XU Yong-tao(Dept of Orthopaedics,Jingzhou Central Hospital,Jingzhou,Hubei 434020,China)

机构地区：[1]荆州市中心医院骨科

出　　处：《临床骨科杂志》2019年第6期712-715,共4页Journal of Clinical Orthopaedics

摘　　要：目的总结第1跖趾关节融合术联合跖趾关节成形术治疗老年拇外翻的临床疗效。方法采用第1跖趾关节融合术矫正18例老年拇外翻患者(20足),并对第2~5趾畸形行跖趾关节成形术,比较术前及末次随访时拇外翻角(HVA)和第1、2跖骨间角(IMA),应用AOFAS评分系统评价临床疗效。结果患者均获得随访,时间9~24个月。末次随访时,矫形足负重正、侧位X线片显示HVA和IMA均较术前显著减小(P<0.001);根据AOFAS评分标准评价临床疗效:优1足,良17足,可2足,治疗优良率为18/20。结论第1跖趾关节融合术联合跖趾关节成形术可有效矫正老年拇外翻前足畸形,减轻疼痛,降低术后前足疼痛的复发率。Objective To summarize the clinical effect of the first metatarsophalangeal joint fusion combined with metatarsophalangeal joint arthroplasty in the treatment of hallux valgus in the elderly.Methods The first metatarsophalangeal arthrodesis was used to correct 18 elderly patients with hallux valgus(20 feet),and metatarsophalangeal arthroplasties were performed on the second to fifth toe deformities.The hallux valgus angle(HVA),intermetatarsal angle(IMA)before operation and at the last follow-up were compared,and the clinical efficacy was evaluated by the American Orthopedic Foot and Ankle society(AOFAS)scoring standard.Results All patients were followed up for 9~24 months.At the last follow-up,the positive and lateral X-ray films of orthopedic foot showed that HVA and IMA were significantly reduced,compared with those before surgery(P<0.001).AOFAS scoring standard was used to evaluate clinical efficacy:excellent in 1 foot,good in 17 feet,fair in 2 feet,and the excellent and good rate of treatment effect was 18/20.Conclusions The first metatarsophalangeal joint fusion combined with metatarsophalangeal joint arthroplasty can effectively correct hallux valgus forefoot deformity in the elderly,relieve pain and reduce the recurrence rate of postoperative forefoot pain.

关 键 词：拇外翻 跖趾关节脱位 跖趾关节融合术 跖趾关节成形术 

分 类 号：R682.6[医药卫生—骨科学] R687.4[医药卫生—外科学]