克氏针联合改良Chevron截骨术对中重度足拇外翻疗效观察  

Effect of Kirschner wire combined with modified Chevron osteotomy on the treatment of moderate to severe hallux valgus

作　　者：韩婷 武永富[2] 庞江娜 赵海燕 张青霞 Han Ting;Wu Yongfu;Pang Jiangna;Zhao Haiyan;Zhang Qingxia(Department of Radiology,The Third Hospital of Shijiazhuang,Shijiazhuang 050011,China;The Third Department of Traumatology,The Third Hospital of Shijiazhuang,Shijiazhuang 050011,China;Department of Endocrinology,Shijiazhuang People's Hospital(Fangbei Campus),Shijiazhuang 050000,China;Department of TCM Orthopedics,The Third Hospital of Shijiazhuang,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第三医院影像科,石家庄050011 [2]河北省石家庄市第三医院创三科,石家庄050011 [3]河北省石家庄市人民医院(方北院区)内分泌科,石家庄050000 [4]河北省石家庄市第三医院中医骨科,石家庄050011

出　　处：《保健医学研究与实践》2024年第9期62-66,共5页Health Medicine Research and Practice

基　　金：河北省医学科学研究课题计划(20251104)。

摘　　要：目的探讨克氏针联合改良Chevron截骨术对中重度足拇外翻的疗效,以期为临床决策的制定提供参考。方法选择河北省石家庄市某医院于2021年1—12月收治的中重度足拇外翻患者120例作为研究对象,依据其手术方法分为观察组与对照组,每组60例。2组患者均行改良Chevron截骨术治疗,观察组在此基础上采用克氏针自足拇指远近节趾骨内上侧穿入第一跖骨近端髓腔。比较术后6个月2组患者的疗效和并发症发生情况;比较2组患者术前和术后6个月跖骨远端关节面角(DMAA)、拇外翻角(HVA)和跖骨间夹角(IMA),美国足踝矫形学会(AOFAS)评分,视觉模拟评分法(VAS)评分;比较2组患者术后12个月足拇外翻复发情况。结果观察组患者疗效优良率高于对照组,差异有统计学意义(P<0.05)。2组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。2组患者术后6个月DMAA、HVA和IMA均小于术前(P<0.05),且观察组均小于对照组(P<0.05)。2组患者术后6个月AOFAS的对线、疼痛、功能维度得分和总分均高于术前(P<0.05),且观察组均高于对照组(P<0.05)。2组患者术后6个月VAS评分均低于术前(P<0.05),且观察组低于对照组(P<0.05)。随访12个月,观察组患者无人复发,对照组患者仅2人复发,2组患者足拇外翻复发率比较,差异无统计学意义(P>0.05)。结论克氏针联合改良Chevron截骨术对中重度足拇外翻疗效显著,可明显改善患者足部功能,减轻患者疼痛,值得临床推广。Objective To explore the effectiveness of Kirschner wire combined with modified Chevron osteotomy in treating moderate to severe hallux valgus,aiming to provide a reference for clinical decision-making.Methods A total of 120 patients with moderate to severe hallux valgus,treated at a hospital in Shijiazhuang,from January to December 2021,were selected for the study.The patients were assigned to two groups based on their surgical approach:the observation group and the control group,with 60 patients in each group.Both groups underwent modified Chevron osteotomy,while the observation group additionally received Kirschner wire insertion through the proximal medullary cavity of the first metatarsal,entering the proximal phalanx of the great toe.The efficacy and complication rates were compared between the two groups 6 months post-surgery.The distal metatarsal articular angle(DMAA),hallux valgus angle(HVA),intermetatarsal angle(IMA),American Orthopaedic Foot and Ankle Society(AOFAS)score,and visual analog scale(VAS)score were compared preoperatively and 6 months postoperatively.The recurrence of hallux valgus at 12 months post-surgery was also compared between the groups.Results The observation group showed a significantly higher rate of excellent and good outcomes than the control group(P<0.05).No significant differences were noted in the complication rates between the two groups(P>0.05).Six months post-surgery,the DMAA,HVA,and IMA in both groups were significantly less than preoperatively(P<0.05),with the observation group showing significantly less values than the control group(P<0.05).The subscale(alignment,pain,and function)and total scores AOFAS in both groups were significantly higher 6 months post-surgery compared to preoperative scores(P<0.05),with the observation group outperforming the control group significantly(P<0.05).The VAS scores were significantly lower 6 months post-surgery than preoperatively in both groups(P<0.05),with the observation group showing a significantly greater reduction than the control

关 键 词：克氏针 改良Chevron截骨术 中重度足拇外翻 

分 类 号：R682.16[医药卫生—骨科学] R687.31[医药卫生—外科学]