改良双刀Chevron截骨配合外侧软组织松解治疗老年[足母]外翻的疗效和安全性评价  

Evaluation of the efficacy and safety of improved double blades Chevron osteotomy combined with lateral soft tissue release in the treatment of hallux valgus in the elderly

作　　者：张文举[1] 张宇[1] 徐善强 李平[1] 王勇[1] 何凯元 曲亭亭 Zhang Wenju;Zhang Yu;Xu Shanqiang;Li Ping;Wang Yong;He Kaiyuan;Qu Tingting(Foot and Ankle Department,Sichuan Provincial Orthopaedic Hospital,Chengdu 610000,Sichuan,China)

机构地区：[1]四川省骨科医院足踝外科,四川成都610000

出　　处：《足踝外科电子杂志》2024年第3期10-13,35,I0002,共6页Electronic Journal of Foot and Ankle Surgery

摘　　要：目的探讨老年[足母]外翻采取改良双刀Chevron截骨配合外侧软组织松解治疗的疗效与安全性。方法选择四川省骨科医院2018年7月至2023年6月收治的60例(72足)老年[足母]外翻患者,采用改良双刀Chevron截骨并配合第一跖趾关节外侧软组织松解术治疗,通过评价美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)评分、视觉模拟评分法(visual analogue scale,VAS)评分、跖骨远端关节角(distal metatarsal articular angle,DMAA)、[足母]外翻角(hallux valgus angle,HVA)、第1-2跖骨间角(first-second intermetatarsal angle,1-2IMA)来评价手术疗效。结果本研究中患者均获得随访,时间12~36个月,2足出现切口延迟愈合,6足出现跖趾关节僵硬且活动受限,1例出现转移性跖痛症,未出现明显畸形愈合、骨不连、延迟愈合、骨痂形成、内固定失效和再骨折等并发症。HVA、IMA、DMAA、VAS评分及AOFAS评分结果:术后即刻、术后6周、末次随访均较术前显著改善(P <0.05)。结论改良双刀Chevron截骨联合外侧软组织松解治疗老年[足母]外翻具有截骨端稳定、骨性愈合快、矫形效果和功能恢复较好等优点。Objective To investigate the efficacy and safety of improved double blades Chevron osteotomy combined with lateral soft tissue release therapy for hallux valgus in the elderly.Methods Sixty elderly patients(72 feet)with hallux valgus admitted to Sichuan Provincial Orthopaedic Hospital from July 2018 to June 2023 were selected and treated with modified double knife Chevron osteotomy combined with lateral soft tissue release of the first metatarsophalangeal joint.The American Orthopaedic Foot and Ankle Society(AOFAS)score,visual analog scale(VAS)score,distal metatarsal angle(DMAA),hallux valgus angle(HVA),and first second metatarsal angle(1-2)were evaluated.Angle,1-2IMA)is used to evaluate the surgical efficacy.Results All patients in this study were followed up for a period of 12~36 months.Delayed wound healing occurred in 2 feet,stiffness and limited mobility of the metatarsophalangeal joint occurred in 6 feet,and 1 case developed metastatic plantar pain.There were no significant complications such as malunion,non union,delayed healing,callus formation,internal fixation failure,or re fracture.HVA,IMA,DMAA,VAS scores,and AOFAS scores showed significant improvement immediately after surgery,6 weeks after surgery,and at the last follow-up compared to preoperative levels(P<0.05).Conclusion Improved double blades Chevronosteotomy combined with lateral soft tissue release in the treatment of hallux valgus in the elderly has the advantages of stable osteotomy,fast bony healing,good orthopedic effect and functional recovery,and is worthy of clinical application.

关 键 词：老年[足母]外翻 跖骨截骨 跖骨-趾骨联合截骨 美国足踝外科协会评分 

分 类 号：R681[医药卫生—骨科学]