Chevron截骨联合骑缝钉固定治疗中重度[足母]外翻的短期疗效分析  

Short-term Efficacy of Chevron Osteotomy Combined with Staple Fixation for Moderate to Severe Hallux Valgus

作　　者：张兴飞 王文成 喻子林 张宇轩 许亚军 Zhang Xingfei;Wang Wencheng;Yu Zilin;Zhang Yuxuan;Xu Yajun(Department of Foot and Ankle Surgery,Wuxi 9th People’s Hospital,Wuxi 214000,Jiangsu,China)

机构地区：[1]无锡市第九人民医院足踝外科,江苏无锡214000

出　　处：《足踝外科电子杂志》2024年第3期18-22,共5页Electronic Journal of Foot and Ankle Surgery

摘　　要：目的 探讨Chevron截骨联合骑缝钉固定在中重度[足母]外翻手术治疗中的短期治疗效果。方法 回顾分析2023年7月至2024年4月在无锡市第九人民医院行Chevron截骨骑缝钉固定的中重度[足母]外翻患者15例,测量并比较手术前后[足母]外翻角(hallux valgus angle,HVA)、第1,2跖骨间夹角(intermetatarsal angle,IMA)、第一跖骨远端关节面角(distal metatarsal articular angle,DMAA),采用美国足踝外科学会(American Orthopedic Foot and Ankle Society,AOFAS)跖趾关节评分系统和视觉模拟评分(visual analogue scale,VAS)来评估临床效果,并随访影像学结果和并发症发生情况。结果 所有患者均获得随访,随访时间4~12(7.17±2.64)个月。末次随访时,无感染和皮肤坏死等切口并发症发生,无血管和神经损伤,未发现螺钉松动、断裂,[足母]趾外形良好。HVA、IMA、DMAA、VAS评分及AOFAS评分术前与末次随访比较有差异,差异有统计学意义(P <0.001)。结论 Chevron截骨联合骑缝钉固定治疗中重度[足母]外翻具有固定牢固、操作简单及效果优良等优点,短期随访显示影像学结果和临床效果满意。Objective To explore the short-term therapeutic efficacy of Chevron osteotomy combined with staple fixation in the surgical treatment of moderate to severe hallux valgus.Methods A retrospective analysis was conducted on 15 patients with moderate to severe hallux valgus who underwent Chevron osteotomy with staple fixation in Wuxi 9th People’s Hospital between July 2023 and April 2024.The hallux valgus angle(HVA),intermetatarsal angle(IMA),and distal metatarsal articular angle(DMAA)were measured and compared before and after surgery.The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society(AOFAS)metatarsophalangeal-interphalangeal joint score and the visual analogue scale(VAS).Radiographic outcomes and complications were also assessed during follow-up.Results All patients were followed up for 4 to 12(7.17±2.64)months.No postoperative complications were observed,such as infection,skin necrosis,or vascular and nerve injury.At the final follow-up,there were no cases of staple fixation loosening or breakage,and the appearance of the hallux was satisfactory.There were significant differences in HVA,IMA,DMAA,VAS scores,and AOFAS scores between preoperative and final follow-up,with statistical significance(P<0.001).Conclusion Chevron osteotomy combined with staple fixation provides firm stabilization,is easy to perform,and yields excellent results.Radiographic outcomes and clinical efficacy were satisfactory during the short-term follow-up.

关 键 词：Chevron截骨 骑缝钉 [足母]外翻 

分 类 号：R681[医药卫生—骨科学]