摘要
[目的]比较Scarf联合改良Weil术式与微创截骨矫正合并跖内收外翻的临床疗效。[方法]2015年1月~2018年12月,本院69例(80足)跖内收外翻患者接受手术治疗。其中,Scarf联合改良Weil术(Scarf截骨组)37例(42足),第1跖骨远端微创截骨(微创组)32例(38足)。比较围手术期、随访与影像资料。[结果]两组患者均顺利完成手术。Scarf截骨组2例切口延迟愈合,微创组1例切口延迟愈合,8例足趾内侧浅感觉障碍。与术前相比,术后3个月两组患者VAS评分显著减少,而AOFAS评分显著增加(P<0.05)。术后3个月Scarf截骨组VAS评分和AOFAS评分均显著优于微创组(P<0.05)。与术前相比,术后两组患者HVA、IMA和MMA均显著减少(P<0.05)。术后Scarf截骨组的IMA和MMA显著优于微创组(P<0.05)。[结论]Scarf联合改良Weil术矫正合并跖内收母外翻早期临床效果优于微创截骨。
[Objective]To compare the early clinical outcomes of Scarf osteotomy combined with Weil osteotomy versus minimally invasive distal first metatarsal osteotomy for metatarsal adduction accompanied with hallux valgus.[Method]From January 2015 to December 2018,69 patients underwent surgical treatment for metatarsal adduction accompanied with hallux valgus.Of them,37 patients(42 feet)received Scarf osteotomy combined with modified Weil osteotomy(the Scarf group),while the remaining 32 patients(38 feet)underwent minimally invasive distal first metatarsal osteotomy(MIO group).The perioperative,follow-up and radiographic documents were compared between the two groups.[Results]All the patients in both groups had operation performed smoothly,however,poor incision healing happened in 2 cases of the Scarf group and 1 case of the MIO group,disturbance of sensation on medial side of the toe was noted in 8 cases of the MIO group.The VAS score significantly decreased,while the AOFAS score significantly increased at 3 months postoperatively compared with those before operation(P<0.05).The Scarf group proved significantly superior to the MIO group regarding to VAS and AOFAS scores at 3 months after operation(P<0.05).In term of radiographic measurements,the hallux valgus angle(HVA),intermetatarsal angle(IMA)and metatarsus adduction angle(MMA)significantly improved after operation in comparison with those preoperatively in both groups(P<0.05).The Scarf group was significantly superior to the MIO group in IMA and MMA postoperatively(P<0.05).[Conclusion]The Scarf osteotomy combined with Weil osteotomy achieves superior early clinical outcomes to minimally invasive distal first metatarsal osteotomy for metatarsal adduction accompanied with hallux valgus.
作者
邹运璇
张宏宁
沈国栋
朱永展
尹航
ZOU Yun-xuan;ZHANG Hong-ning;SHEN Guo-dong;ZHU Yong-zhan;YIN Hang(Department of Foot and Ankle Surgery,Foshan Traditional Chinese Medicine Hospital,Foshan 528000,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2020年第17期1573-1577,共5页
Orthopedic Journal of China
基金
国家自然科学基金青年基金项目(编号:81601911)。
