摘要
目的研究微创切口无内固定置入术治疗外翻畸形的临床有效性及安全性。方法选取2013年1月-2016年3月收治的82例(142足)外翻患者,采用随机数表法将其分为两组,其中观察组42例(71足)采用小切口微创技术,术后采用"8"字绷带外固定;对照组40例(71足)采用传统截骨内固定术治疗,术后采用石膏外固定。测量和比较两组术前和术后6个月的外翻角(HVA)、跖骨间角(IMA)、跖骨远端关节角(DMAA)、跖趾关节矢状面活动度并进行足踝AOFAS评分,比较两种手术的优良率及并发症发生率、平均住院费及住院时间。结果术前观察组与对照组HVA、DMAA、IMA、跖趾关节活动度及AOFAS评分比较,差异无统计学意义(P>0.05)。术后6个月两组HVA、DMAA、IMA、跖趾关节活动度及AOFAS评分与术前比较,两组HVA、DMAA及IMA明显减小,AOFAS评分显著优于术前,观察组跖趾关节活动度较术前改善,差异均有统计学意义(P<0.05),对照组跖趾关节活动度与治疗前比较差异无统计学意义(P>0.05)。术后6个月两组间HVA、DMAA及IMA比较,差异无统计学意义(P>0.05),观察组跖趾关节活动度及AOFAS评分优于对照组,差异均有统计学意义(P<0.05)。观察组的优良率为92.96%,明显高于对照组的82.86%,差异有统计学意义(P<0.05);两组的平均住院费(元)(0.75±0.16VS1.92±0.63)、平均住院时间(d)(5.33±1.62VS9.17±2.40)及并发症发生率(0%VS4.29%)比较,观察组均明显低于对照组,差异均有统计学意义(P<0.05)。结论微创治疗外翻与传统大切口手术比较,具有切口小、优良率高、治疗费用低、住院时间短的特点,是一种安全有效的治疗方法,值得临床推广应用。
Objective To study the clinical efficacy and safety of minimally invasive incision without internal fixation in the treatment of hallux valgus deformity.Methods A prospective study was conducted among inpatients in the Department of Orthopedics,Liuzhou workers’hospital from January 2013 to March 2016.The patients were divided into two groups by random number table method,42 cases(71 feet)in the treatment group treated with small incision minimally invasive technique and external fixation with"8"bandage after operation.40 cases(71 feet)in the control group were treated with traditional osteotomy and fixation with plaster external fixation.The HVA,the intermetatarsal angle(IMA),the distal metatarsal joint angle(DMAA),the sagittal plane activity of the metatarsopatarsophalangeal joint and the AOFAS score of the ankle were measured before and after the operation for 6 months,and then to compare the excellent and good rates,the incidence of complications,the average hospitalization expenses and the average length of stay of the two groups.Results Before operation,the HVA(degrees,°),DMAA(degrees,°),IMA(degrees,°),metatarsophalangeal joint mobility(degrees,°)and AOFAS scores(points)in the minimally invasive group and the control group.There was no significant difference in the above two indexes before operation(P>0.05).6 months after operation,HVA(degrees,°),DMAA(degrees,°),IMA(degrees,°),metatarsophalangeal joint mobility(degrees,°)and AOFAS scores(points)in the minimally invasive group and the control group.Compared with preoperative,the HVA,DMAA and IMA decreased significantly in the two groups(P<0.05)after the operation for 6 months,and the AOFAS score was significantly better than that before operation(P<0.05).The activity of metatarsophalangeal joints in the minimally invasive group was better than that before the operation(P<0.05),and there was no significant difference in the control group(P>0.05).Six months after operation,there was no significant difference in HVA,DMAA and IMA between the two groups(
作者
李文升
张强
李瑞龙
LI Wensheng;ZHANG Qiang;LI Ruilong(Department of Spine Surgery,Hezhou People's Hospital,Hezhou,Guangxi,542899,China)
出处
《实用手外科杂志》
2020年第4期428-433,共6页
Journal of Practical Hand Surgery
关键词
微创手术
传统手术
外翻
“8”字绷带固定
疗效
Minimally invasive operation
Traditional operation
Hallux valgus
Fixed with"8"shaped bandage
Effect
