Akin截骨术在拇外翻矫形中的疗效分析  

Outcomes after osteotomy for hallux valgus with and without Akin osteotomy:A retrospective comparative study

作　　者：孙宁 杨晓松 李恒 卢班 武勇 Sun Ning;Yang Xiaosong;Li Heng;Lu Ban;Wu Yong(Department of Foot and Ankle Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing,100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院足踝外科,北京100035

出　　处：《生物骨科材料与临床研究》2025年第1期44-48,共5页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨Akin截骨术在拇外翻矫形中的临床疗效。方法回顾性分析首都医科大学附属北京积水潭医院足踝外科2018年3月至2021年8月收治住院的拇外翻患者的临床资料。共纳入患者51例(57足):根据是否行Akin手术分为Akin组和非Akin组。Akin组22足,其中左侧11足,右侧11足;非Akin组35足,其中左侧21足,右侧14足。选取术前趾骨远近端关节面角(proximal to distal phalangeal articular angle,PDPAA)>8°的患者,从术后影像学效果评价(术后拇外翻角,第1、2跖骨间角,趾骨远近端关节面角,胫侧籽骨位置)、临床功能评价(美国足踝外科协会前足评分、疼痛视觉模拟评分)、患者满意度调查三个方面对拇外翻矫形过程中Akin组和非Akin组患者的手术效果进行比较。结果术后随访6~36个月,平均(14.70±6.91)个月。两组患者术前PDPAA比较,差异无统计学意义(P>0.05);Akin组末次随访时PDPAA为(4.69±2.53)°,非Akin组末次随访时PDPAA为(13.80±4.41)°,两组间比较差异有统计学意义(P<0.05);两组患者术前、末次随访的拇外翻角,第1、2跖骨间角,趾骨远近端关节面角,胫侧籽骨位置比较,差异均无统计学意义(P>0.05)。两组的术前、末次随访时AOFAS评分及疼痛VAS评分比较,差异均无统计学意义(P>0.05),复发率和总体满意率无差异,但Akin组对外观的满意率更高。结论Akin组与非Akin组的术后影像学指标、临床功能评分及复发率方面无显著差异,但在患者满意度方面,Akin手术有助于提高患者对术后外观的满意度。Objective To evaluate the clinical outcomes of Akin osteotomy in the correction of hallux valgus.Methods A retrospective analysis was conducted on the clinical data of hallux valgus patients admitted to Beijing Jishuitan Hospital,Capital Medical University from March 2018 to August 2021.A total of 51 patients(57 feet)were included and divided into the Akin group and the non-Akin group based on whether they underwent Akin osteotomy,with 22 feet in the Akin group(11 left feet,11 right feet)and 35 feet in the non-Akin group(21 left feet,14 right feet).Patients with a preoperative proximal to distal phalangeal articular angle(PDPAA)greater than 8°were selected.The surgical outcomes of patients who underwent Akin osteotomy were compared focusing on postoperative radiographic results,clinical functional evaluation,and patient satisfaction surveys.Results The average follow-up period was 6-36 months,with an average of(14.70±6.91)months.There was no significant difference in preoperative PDPAA between the two groups.At the final follow-up,the Akin group had a PDPAA of(4.69±2.53)°,significantly lower than the non-Akin group,which had a PDPAA of(13.80±4.41)°(P<0.05).No significant differences were observed between the two groups in terms of preoperative and final followup hallux valgus angle,1st-2nd intermetatarsal angle,PDPAA,or medial sesamoid position(P>0.05).Similarly,no significant differences were found between the two groups in preoperative and final follow-up American Orthopaedic Foot and Ankle Society(AOFAS)scores,visual analog scale(VAS)pain scores,recurrence rates,or overall satisfaction(P>0.05).However,the Akin group reported higher satisfaction with postoperative appearance.Conclusion While the Akin osteotomy does not reduce the recurrence rates or improve patient functional scores postoperatively,it does enhance patient satisfaction with the postoperative appearance.

关 键 词：拇外翻 Akin手术 截骨术 

分 类 号：R682.6[医药卫生—骨科学]