第1跖骨近端推移截骨治疗中重度足(足母)外翻  

Proximal first metatarsal lateral displacement osteotomy for moderate to severe hallux valgus

作　　者：庄宇嘉 王光辉[2] 陈小强 李嘉贝 赵喆[2] 李文翠[2] 刘建全[2] ZHUANG Yu-jia;WANG Guang-hui;CHEN Xiao-qiang;LI Jia-bei;ZHAO Zhe;LI Wen-cui;LIU Jian-quan(Medical College,Shantou University,Shantou,Guangdong 515041,China;Department of Hand and Foot Surgery,The Second People's Hospital of Shenzhen City,Shenzhen University,Shenzhen,Guangdong 518000,China)

机构地区：[1]汕头大学医学院,广东汕头515041 [2]深圳市第二人民医院足踝外科手外科,广东深圳518000

出　　处：《中国矫形外科杂志》2025年第6期557-560,共4页Orthopedic Journal of China

基　　金：深圳市第二人民医院院内课题(编号:20223357007);深圳市卫生计生委三名项目(编号:SZSM202311008);深圳市重点医学学科建设基金项目(编号:SZXK025)。

摘　　要：[目的]探讨第1跖骨近端推移截骨治疗中重度足(足母)外翻的临床疗效。[方法]2019年1月—2023年3月深圳第二人民医院采用近端推移截骨术治疗的21例中重度(足母)外翻患者纳入本研究,其中男2例,女19例;平均(59.4±10.5)岁。评价临床及影像结果。[结果]所有患者均顺利完成手术。患者均获随访,随访时间平均(7.4±3.5)个月。与术前相比,末次随访时,患者VAS评分[(2.7±0.8),(0.3±0.5),P<0.001]显著减少,AOFAS评分[(42.8±3.2),(94.0±2.7),P<0.001]显著增加。影像方面,与术前相比,末次随访,(足母)外翻角(hallux valugs angle,HVA)[(40.5±7.4)°,(11.3±4.0)°,P<0.001]、跖骨间角(intermetatarsal anlge,IMA)[(16.0±2.8)°,(6.7±3.2)°,P<0.001]、跖骨远端关节固有角(distal metatarsal articular angle,DMAA)[(17.3±9.4)°,(6.9±4.0)°,P<0.001]均显著减小,籽骨Handy-Clapham分度显著改善(P<0.05),第1跖骨相对长度(relative first metatarsal length,RML)无显著变化(P>0.05)。[结论]第1跖骨近端推移截骨术能有效矫正(足母)外翻畸形,改善患者临床症状。[Objective]To evaluate the short term clinical outcome of proximal first metatarsal lateral displacement osteotomy for the treatment of moderate to severe hallux valgus.[Methods]From January 2019 to March 2023,21 patients with moderate to severe hallux valgus were treated by proximal displacement osteotomy in our hospital,including 2 males and 19 females aged(59.4±10.5)years on an average.The clinical and imaging data were evaluated.[Results]All patients were operated on successfully,and were followed up for an average of(7.4±3.5)months.Compared with those preoperatively,the VAS scores[(2.7±0.8),(0.3±0.5),P<0.001]significantly reduced,while AOFAS score[(42.8±3.2),(94.0±2.7),P<0.001]significantly increased at the latest follow-up.In terms of imaging,the hallux valugs angle(HVA)[(40.5±7.4)°,(11.3±4.0)°,P<0.001],intermetatarsal anlge(IMA)[(16.0±2.8)°,(6.7±3.2)°,P<0.001]significantly decreased,whereas the distal metatarsal articular angle(DMAA)[(17.3±9.4)°,(6.9±4.0)°,P<0.001],Handy-Clapham scale of sesamoid bone significantly improved(P<0.05),despite of that the relative first metatarsal length(RML)remained unchanged(P>0.05).[Conclusion]The first proximal metatarsal displacement osteotomy does effectively correct valgus deformity and improve the clinical symptoms of patients.

关 键 词：(足母)外翻 跖骨近端截骨术 第1、2跖骨间夹角 跖骨远端关节固定角 

分 类 号：R682.16[医药卫生—骨科学]