Ludloff截骨术和Chevron截骨术治疗足拇外翻畸形疗效对比  

Comparison on the Curative Effect of Ludloff Osteotomy and Chevron Osteotomy on Hallux Valgus Deformity

作　　者：刘航 祁峰[2] 刘德成 LIU Hang;QI Feng;LIU Decheng(Hubei University of Science and Technology,Xianning 437100,Hubei,China;Department of Plastic Surgery,Heilongjiang Provincial Hospital,Harbin 150036,Heilongjiang,China;Department of Plastic Surgery,Harbin Rongmei Hospital,Harbin 150096,Heilongjiang,China)

机构地区：[1]湖北科技学院,湖北咸宁437100 [2]黑龙江省医院整形外科,黑龙江哈尔滨150036 [3]哈尔滨荣美医院整形外科,黑龙江哈尔滨150096

出　　处：《中国美容医学》2023年第2期60-63,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨Ludloff截骨术和Chevron截骨术治疗足拇外翻(Halluxvalgus,HV)畸形的效果。方法:选取2021年1月-2021年12月在笔者医院行截骨术治疗的HV畸形患者109例,根据不同手术方式分为Ludloff组(行Ludloff截骨术)55例(60足)和Chevron组(行Chevron截骨术)54例(58足)。观察并比较两组患者临床疗效优良率,以美国足踝评分系统(American orthopaedics foot and ankle score,AOFAS)评估两组足踝功能,以X线片测定两组患者拇外翻角(Hallux valgus angle,HVA)、第Ⅰ、Ⅱ跖骨间角(Intermetatarsal angle,IMA)及第1跖骨远关节面角(Distal metatarsalarticularangel,DMAA),并统计两组术后并发症发生情况。结果:术后,Ludloff组和Chevron组优良率比较差异无统计学意义(P>0.05);但Chevron组临床疗效为优的比例(89.66%)高于Ludloff组(75.00%),差异有统计学意义(P<0.05)。术后3个月,两组AOFAS评分均显著升高,且Chevron组评分高于Ludloff组,差异有统计学意义(P<0.05);两组HVA、IMA、DMAA指标均显著下降,且Chevron组低于Ludloff组,差异有统计学意义(P<0.05)。两组术后均未发生感染等严重并发症。结论:Ludloff截骨术和Chevron截骨术治疗HV畸形均有良好效果,可改善HVA、IMA、DMAA角度,改善患者足踝功能,且Chevron截骨术的效果更佳,值得临床推广应用。Objective To explore the curative effect of Ludloff osteotomy and Chevron osteotomy on hallux valgus(HV)deformity. Methods A total of 109 patients with HV deformity undergoing osteotomy in the hospital were enrolled between January and December 2021. According to different surgical methods, they were divided into the Ludloff group(Ludloff osteotomy, 55 cases, 60 feet) and the Chevron group(Chevron osteotomy, 54 cases, 58 feet). The good rate of clinical curative effect was compared between the two groups. The ankle function of patients was evaluated by American orthopaedic foot and ankle society(AOFAS). The hallux valgus angle(HVA), Ⅰ、Ⅱ intermetatarsal angle(IMA) and the first distal metatarsal articular angel(DMAA) in both groups were measured by X-ray films. The occurrence of surgical complications in both groups was statistically analyzed. Results After surgery, there was no significant difference in good rate between the two groups(P>0.05). The good rate of clinical curative effect in the Chevron group was higher than that in the Ludloff group(89.66% vs 75.00%), the difference was statistically significant(P<0.05). At 3 months after surgery, AOFAS scores in both groups were significantly increased, which were higher in the Chevron group than the Ludloff group(P<0.05). At 3 months after surgery, HVA, IMA and DMAA in both groups were significantly decreased, which were lower in the Chevron group than the Ludloff group(P<0.05). There were no serious complications in two groups after surgery. Conclusion The curative effect of both Ludloff osteotomy and Chevron osteotomy is good on HV deformity, which can improve HVA, IMA, DMAA and ankle function of patients. The effect of Chevron osteotomy is better.

关 键 词：足拇外翻 Ludloff截骨术 Cheveron截骨术 矫正效果 足踝功能 

分 类 号：R622[医药卫生—整形外科]