Chevron截骨联合改良Mcbride手术治疗轻中度拇外翻畸形  

Chevron osteotomy combined with modified McBride procedure in the treatment of mild to moderate hallux valgus

作　　者：周荣[1] 刘跃飞[1] 胡昌庆[1] 杨亮 唐林峰[1] 巨积辉[1] ZHOU Rong;LIU Yue-fei;HU Chang-qing;YANG Liang;TANG Lin-feng;JU Ji-hui(Department of Foot and Ankle Surgery,Rui-hua Affiliaed Hospitel of Soochow University,Siuzhous 215104,China)

机构地区：[1]苏州大学附属瑞华医院足踝外科,江苏苏州215104

出　　处：《中国美容整形外科杂志》2020年第12期716-719,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨采用第1跖骨远端Chevron截骨联合改良Mcbride手术治疗轻中度拇外翻畸形的临床疗效。方法自2015年10月至2019年6月,采用第一跖骨远端Chevron截骨联合改良Mcbride手术对15例(17足)轻中度拇外翻患者进行治疗,伴第2、3、4跖骨头下疼痛并胼胝体形成者同时行Weil截骨治疗。患足手术前后拍摄负重正侧位片,测量拇外翻角(hallux valgus angle,HVA),第1、2跖骨间夹角(intermetatarsal angle,IMA),观察籽骨位置、关节匹配情况,以美国足踝骨科学会(american orthopaedic foot and ankle society,AOFAS)前足评分系统进行功能评定。结果术后随访3~23个月,平均13个月,术前HVA为16.7°~37.8°,平均31.2°;IMA为11.3°~15.7°,平均14.7°;AOFAS前足评分为40~65分,平均52分。术后末次随访HVA为5.7°~17.6°,平均11.5°;IMA为7.4°~13.2°,平均12.1°;AOFAS前足评分为82~95分,平均87分。结论采用第1跖骨远端Chevron截骨联合改良Mcbride手术治疗轻中度拇外翻畸形,术后影像学角度改善较明显,患者的满意度较高,对轻中度拇外翻畸形的矫正效果较好。Objective To explore the clinical efficacy of distal Chevron osteotomy of the first metatarsal combined with modified Mc Bride procedure in the treatment of mild to moderate hallux valgus.Methods From October 2015 to June 2019,15 patients(17 feet)with mild to moderate hallux valgus were treated by distal Chevron osteotomy of the first metatarsal combined with modified Mc Bride procedure.Those who had the metatarsalgia under the second,third and fourth metatarsal head with the formation of corpus callosum underwent Weil osteotomy.The weight-bearing radiography of the foot was taken before and after surgery,the hallux valgus angle(HVA)and the angle between the 1 st and 2 nd metatarsal bones(intermetatarsal angle,IMA)were measured,the sesamoid position and joint matching situation were observed,the ankle function was evaluated according to the American Orthopaedic Foot and Ankle Society(AOFAS)forefoot scoring system.Results The follow-up ranged from 3 to 23 months,with an average of 13 months.The preoperative HVA ranged from16.7°to 37.8°,with an average of 31.2°;IMA was from 11.3°to 15.7°,with an average of 14.7°;AOFAS forefoot score was from 40 to 65,with an average of 52 points.At the last follow-up,HVA ranged from 5.7°to 17.6°,with an average of 11.5°;IMA ranged from 7.4°to13.2°,with an average of 12.1°;AOFAS forefoot score was from 82 to 95,with an average of 87.Conclusion The postoperative imaging angle are significantly improved and satisfaction is high in the mild to moderate hallux valgus patients under went distal Chevron osteotomy of the first metatarsal combined with modified Mc Bride procedure.The clinical efficacy of the correction for mild to moderate hallux valgus deformity is satisfactory.

关 键 词：拇外翻 Chevron截骨 改良Mcbride手术 

分 类 号：R658.2[医药卫生—外科学]