足内侧跖楔关节融合联合Akin截骨治疗中、重度踇外翻临床研究  

Clinical study of medialis pedis tarsometatarsal joint fusion combined with Akin osteotomyon moderate-to-severe hallux valgus

作　　者：黄远清[1] 易远历 朱亚平[1] Huang Yuanqing;Yi Yuanli;Zhu Yaping(Department of Hand and Foot Surgery,Huizhou Central People’s Hospital,Huizhou 516001,China)

机构地区：[1]广东省惠州市中心人民医院手足外科,惠州516001

出　　处：《广西医科大学学报》2021年第1期161-165,共5页Journal of Guangxi Medical University

基　　金：广东省医学科研基金资助项目(No.2017Y018)

摘　　要：目的:探讨足内侧跖楔关节融合联合Akin截骨治疗中、重度踇外翻的临床疗效。方法:回顾性分析60例中、重度踇外翻患者的临床资料,根据治疗方案不同将患者分为观察组(足内侧跖楔关节融合+Akin截骨治疗,33例)和对照组(足内侧跖楔关节融合治疗,27例)。观察两组手术前后踇外翻角(HAV)、第1跖骨间角(IMA)、美国足踝外科医师协会(AOFAS)踝-后足功能评分,比较HAV、IMA矫正度数、手术优良率及并发症发生情况。结果:末次随访时,两组患者HAV、IMA均较术前缩小,AOFAS评分较术前明显升高(P<0.05),观察组患者HAV明显小于对照组,AOFAS评分明显高于对照组,矫正度数明显大于对照组(均P<0.05);观察组患者优良率明显高于对照组(P<0.05),两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论:足内侧跖楔关节融合联合Akin截骨治疗中、重度踇外翻可有效纠正足畸形,改善踝及后足功能、外观,达到满意疗效且安全性高。Objective:To explore the clinical efficacy of medialis pedis tarsometatarsal joint fusion combined with Akin osteotomy on moderate-to-severe hallus valgus.Methods:Clinical data of 60 patients with moderate-tosevere hallus valgus were retrospectively analyzed.According to different treatment regimens,the patients were divided into an observation group(medialis pedis tarsometatarsal joint fusion+Akin osteotomy,33 cases)and a control group(medialis pedis tarsometatarsal joint fusion,27 cases).Hallux valgus angle(HAV),first intermetatarsal angle(IMA)and ankle-hindfoot function score of American Orthopedic Foot and Ankle Society(AOFAS)were observed before and after surgery.Correction degrees of HAV and IMA,excellent and good rate of surgery and complications were compared.Results:At the last follow-up,HAV and IMA in both groups were lower than those before surgery,and AOFAS score was higher(P<0.05).HAV in the observation group was lower than that in the control group,while AOFAS score,correction degree,and excellent and good rate were significantly higher(P<0.05).There was no significant difference in the incidenceof complications between the two groups(P>0.05).Conclusion:Medialis pedis tarsometatarsal joint fusion combined with Akin osteotomy for moderate-to-severe hallux valgus can effectively correct foot deformity and improve the function and appearance of ankle and hindfoot,with satisfactory efficacy and high safety.

关 键 词：足内侧跖楔关节融合 Akin截骨 踇外翻 AOFAS 

分 类 号：R687[医药卫生—骨科学]