可吸收螺钉内固定截骨矫形治疗拇外翻的临床效果分析  

Clinical effect of absorbable screw fixation in osteotomy for hallux valgus

作　　者：张春晖[1] 吕振刚[1] 王琪 张亚奎[1] Zhang Chunhui;Lyu Zhengang;Wang Qi;Zhang Yakui(Department of Hand and Foot Surgery,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China)

机构地区：[1]首都医科大学附属北京潞河医院手足外科,101149

出　　处：《北京医学》2020年第10期955-958,共4页Beijing Medical Journal

摘　　要：目的探讨可吸收螺钉内固定截骨矫形治疗拇外翻的临床价值。方法选取2016年1月至2018年6月首都医科大学附属北京潞河医院收治的中重度拇外翻患者45例(49足),均为女性,平均年龄(49.0±3.3)岁,采用截骨矫形,可吸收螺钉或金属钉板内固定手术治疗。可吸收螺钉组23例(26足),金属钉板组22例(23足);术后定期复查X线及功能随访。比较两组术前及末次随访时的美国矫形足踝协会(American Orthopedic Foot and Ankle Society,AOFAS)评分、视觉模拟评分(visual analogue score,VAS),术前及末次随访时的拇外翻角(hallux valgus angle,HVA),第1、2跖骨间角(intermetatarsal angle,IMA),手术时间、平均住院日、截骨愈合时间。结果患者均获随访,平均(10.3±1.4)个月。末次随访时总体AOFAS评分优37例、良6例、可2例,优良率95.6%。末次随访时总体VAS、HVA、IMA改善明显(P<0.05),组间比较差异均无统计学意义(P>0.05)。患者截骨处均获骨性愈合,平均愈合时间(5.7±0.2)周,两组手术时间、平均住院日、术后截骨愈合时间比较,差异均无统计学意义(P>0.05)。结论可吸收螺钉内固定截骨矫形治疗拇外翻临床疗效肯定,避免了金属内植物激惹,不需二次手术取内固定,值得临床推广。Objective To evaluate the clinical effect of absorbable screw fixation in osteotomy for hallux valgus.Methods Form January 2016 to June 2018,45 patients(49 feet)with moderate and severe hallux valgus were admitted.Surgical treatment of osteotomy was given,including absorbable screws internal fixation in 23 cases(26 feet)and metal screws plate internal fixation in 22 cases(22 feet).X-ray and functional follow-up were reviewed postoperatively.The American Orthopedic Foot and Ankle Society(AOFAS)score,visual analogue scale(VAS),hallux valgus angle(HVA),intermetatarsal angle(IMA)of the two groups were compared perioperatively and at the last follow-up.Operation time,average hospitalization day,osteotomy healing time of the two groups were compared.Results All patients were followed up with an average time of(10.3±1.4)months.Excellent(37 cases)and good rate(6 cases)of AOFAS score were 95.6%.The VAS,HVA,IMA were improved significantly(P<0.05)in both groups at the last follow-up.There were no significant differences between the two groups perioperatively and at last follow-up in AOFAS score,VAS,HVA and IMA(P>0.05).Bone healing was achieved in all patients,with an average time of(5.7±0.2)weeks.There were no significant differences between the two groups in operation time,average hospitalization day,osteotomy healing time(P>0.05).Conclusions The clinical effect is positive of absorbable screw fixation in osteotomy for hallux valgus,which avoides the internal irritation,no secondary surgery is required.It can be popularized in clinic.

关 键 词：可吸收螺钉 内固定 拇外翻 截骨术 

分 类 号：R658.3[医药卫生—外科学]