摘要
[目的]评估中西医结合改良Chevron截骨植骨并行裹帘法外固定治疗伴骨质疏松症中度外翻畸形的疗效。[方法]回顾性分析2015年1月至2016年6月于我科采用改良Chevron截骨裹帘固定治疗的18例伴骨质疏松的中度外翻患者资料,所有患者术中均行改良长跖侧截骨面Chevron截骨术,并转移植骨,术后均应用中医"裹帘法"固定。对比测量患者术前、术后外翻角(hallux valgus angle,HVA)、第1、2跖骨间角(intermetatarsal angle,IMA)。采用美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)第一跖趾关节评分标准综合评估,以视觉模拟评分法(visual analogue scale,VAS)评估疼痛程度的变化,应用Glynn标准进行满意度评估。[结果]18例患者均获随访,随访时间18～34个月,平均(21.8±3.5)个月。末次随访时与术前比较,患者HVA、IMA明显缩小,AOFAS评分增高,VAS评分降低,差异均有统计学意义(P<0.01)。植骨后截骨端均在术后8周内临床愈合,无感染,随访期间无跖骨头坏死。Glynn标准满意度评估提示无不满意病例。[结论]基于伴骨质疏松症外翻的特点,可通过改良Chevron截骨转移植骨并裹帘法外固定的中西医结合方法有效治疗。
[Objective]To evaluate the clinical efficacy of modified offset V distal Chevron osteotomy and bone graft and wrapped curtain method external fixation in treating hallux valgus deformities of osteoporotic patients.[Methods]From January 2015 to June 2016,18 osteoporotic patients(1 man and 17 women) 18 feet hallux valgus deformities were treated with modified offset V distal Chevron osteotomy and bone graft and wrapped curtain method external fixation.The hallux valgus angle(HVA),intermetatarsal angle(IMA),visual analogue scale(VAS) and American Orthopaedic Foot and Ankle Society(AOFAS) hallux metatarsophalangeal,interphalangeal clinical rating score before operation were compared with that after operation.The Glynn standard was used to assess the satisfaction of treatment.[Results]All patients tolerated the procedure well.Complications such as infection or bone nonunion were not demonstrated in the study.There were no dissatisfaction patients.The HVA,IMA,VAS and AOFAS hallux metatarsophalangeal interphalangeal clinical rating score were improved obviously(P <0.01).[Conclusion]Modified offset V distal Chevron osteotomy and bone graft and wrapped curtain method external fixation is a safe,conveniently and effective therapy for hallux valgus deformities of osteoporotic patients.
作者
顾晓晖
毕擎
夏冰
洪剑飞
GU Xiaohui;BI Qing;XIA Bing(Deportment of Orthopaedic,Zhejiang Provincal People's Hospital,Hangzhou(310014),China)
出处
《浙江中医药大学学报》
CAS
2018年第12期1029-1033,共5页
Journal of Zhejiang Chinese Medical University
基金
浙江省中医药科技计划项目(2014ZA004)~~
关键词
中西医结合
[足母]外翻
改良Chevron截骨术
植骨
裹帘法
骨质疏松症
integrated traditional Chinese and western medicine
hallux valgus
modified Chevron osteotomy
bone graft
wrapped curtain method
osteoporosis
