传统与改良Chevron截骨术联合外侧软组织松解治疗轻中度(足母)外翻畸形的疗效比较  

Efficacy Comparison of Traditional and Modified Chevron Osteotomy Combined with Lateral Soft Tissue Release in the Treatment of Mild to Moderate Hallux Valgus Deformity

作　　者：洪泽亚 李建华 肖耀广 Hong Zeya;Li Jianhua;Xiao Yaoguang(Department of Orthopaedics,Hubei Provincial Hospital of Integrative Chinese&Western Medicine,Wuhan 430000,China;Hubei University of Traditional Chinese Medicine,Wuhan 430000,China)

机构地区：[1]湖北省中西医结合医院骨科,武汉430000 [2]湖北中医药大学,武汉430000

出　　处：《骨科》2024年第4期327-331,共5页ORTHOPAEDICS

摘　　要：目的比较传统Chevron截骨术(traditional Chevron osteotomy,TCO)与改良Chevron截骨术(modified Chevron osteotomy,MCO)联合外侧软组织松解治疗轻中度(足母)外翻畸形的临床疗效。方法选取2021年1月至2022年12月于湖北省中西医结合医院行手术治疗的31例轻/中度(足母)外翻病人,其中女27例,男4例,平均年龄为46.5岁(31~62岁)。左足17例,右足14例。根据手术方式分为TCO组(16例)与MCO组(15例)。记录病人术前及术后6周、1年随访时(足母)外翻角(hallux valgus angle,HVA)、跖骨间角(intermetatarsal angle,IMA)、跖趾关节活动度(range of motion,ROM)、美国足踝外科医师协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足功能评分、疼痛视觉模拟量表(visual analogue scale,VAS)评分和术后满意度。结果两组病人术后HVA、IMA、ROM、AOFAS、VAS均较术前改善(P<0.05)。组间比较,MCO组AOFAS评分、VAS评分优于TCO组(P<0.05)。术后6周两组间ROM比较,差异有统计学意义(P<0.05),1年随访时差异无统计学意义(P>0.05)。两组间HVA及IMA未发现统计学差异(P>0.05)。结论TCO和MCO手术均可改善轻中度(足母)外翻畸形症状,矫正关节畸形,消除疼痛,恢复正常行走,临床疗效至少持续一年。Objective To compare the clinical efficacy of traditional Chevron osteotomy(TCO)and modified Chevron osteotomy(MCO)combined with lateral soft tissue release in the treatment of mild to moderate bunion deformity.Methods A total of 31 patients with mild/moderate bunion deformity who underwent surgical treatment at Hubei Combined Hospital of Traditional Chinese and Western Medicine from January 2021 to December 2022 were selected,including 27 females and 4 males,with a mean age of 46.5 years(31⁃62 years).There were 17 cases of left foot and 14 cases of right foot.The patients were divided into TCO group(16 cases)and MCO group(15 cases)according to the surgical approach.The hallux valgus angle(HVA),intermetatarsal angle(IMA),range of motion(ROM),American Orthopaedic Foot and Ankle Society(AOFAS),and visual analogue scale(VAS)at the preoperative,6⁃week,and 1⁃year follow⁃up visits,and postoperative satisfaction were recorded.Results HVA,IMA,ROM,AOFAS,and VAS were improved after operation in both groups compared to those preoperation(P<0.05).The AOFAS and VAS scores in the MCO group were better than those in the TCO group(P<0.05).Comparison of ROM between the two groups at 6th week postoperatively showed a statistically significant difference(P<0.05),and the difference was not statistically significant at the 1⁃year follow⁃up(P>0.05).No statistical difference was found in HVA and IMA between the two groups(P>0.05).Conclusion Both TCO and MCO surgery can improve hallux valgus symptoms for at least one year,correct joint deformity,eliminate pain,and restore normal walking.

关 键 词：Chevron截骨术 软组织松解 (足母)外翻 改良Chevron截骨术 

分 类 号：R687.3[医药卫生—骨科学]