摘要
目的探讨通过Silver结合第一跖骨头关节面切除在老年性拇外翻治疗方面的疗效。方法自2016年1月至2018年1月予以Silver结合第一跖骨头关节面切除手术治疗老年性拇外翻患者74例,男3例,女71例,年龄64~86(74.3±0.2)岁,术后不使用外固定,鼓励其早期下床功能锻炼,随访并常规拍摄X线,测定患足HVA、IMA角度并予以记录;采用美国足踝外科协会踝-足评分量表进行客观评价。结果所有患者均获得随访,时间16~36(25.3±0.5)个月;术前HVA(37.68°±3.24°),术后12个月矫正至(11.41°±3.1°);术前IMA(9.61°±2.52°),术后12个月矫正至(8.32°±2.43°);术前AOFAS评分(30.52±3.21)分,术后12个月达到(83.61±10.92)分,比较差异有统计学意义(P<0.05)。结论Silver结合第一跖骨头关节面切除手术不仅可用于治疗老年性轻中度拇外翻,而且对于伴有第一跖趾关节退行性关节炎的重度拇外翻患者亦有良好的疗效,无需截骨,无需外固定,矫形效果满意,适合无特殊截骨器械及内固定材料的医院应用。
Objective To explore the effect of Silver combined with the first metatarsal head facetectomy in the treatment of senile hallux valgus.Methods From January 2016 to January 2018,74 elderly patients with hallux valgus were treated by modified Silver combined with the first metatarsal head facetectomy,including 3 males and 71 females,aged 64-86(74.3±0.2)years old.No external fixation was used after the operation.The early functional exercise was encouraged.Follow-up and routine X-ray were taken.The angles of HVA and IMA of the affected foot were measured and recorded.The ankle-foot scale of American Association of Foot and Ankle Surgery was used to evaluate objectively.Results All patients were followed up for 16-36(25.3±0.5)months.Preoperative HVA(37.68°±3.24°)was corrected to(11.41°±3.1°)12 months after the operation.IMA was(9.61°±2.52°)before surgery and(8.32°±2.43°)12 months after surgery.Preoperative AOFAS score was(30.52±3.21)and postoperative 12 months was(83.61±10.92).The difference was statistically significant(P<0.05).Conclusion The improved Silver in combination with the first plantar bone joint surgery,not only can be used in the treatment of senile mild-to-moderate hallux valgus,and accompanied by the first plantar toe joint degenerative arthritis patients with severe hallux valgus also has a good curative effect,without having to cut bone,without fixed outside,orthopedic effect is satisfied,which is suitable for hospital application without special bone cutting equipment and internal fixation materials.
作者
曾舸
吴若岚
晏慧超
郭亚洲
ZENG Ge;WU Ruolan;YAN Huichao;GUO Yazhou(Department of Orthopedics,The Third People′s Hospital of Hubei Province,Wuhan 430033,Hubei,China;Department of Anesthesiology,The Central Hospital of Wuhan,Wuhan 430014,Hubei,China)
出处
《江汉大学学报（自然科学版）》
2021年第6期58-62,共5页
Journal of Jianghan University：Natural Science Edition
