摘要
目的 探讨Akin截骨术联合第一跖骨基底截骨术(Juvara截骨术)治疗中重度拇外翻(HV)的疗效及安全性。方法 选取2019年1月至2021年12月在我院行截骨术治疗的中重度HV患者103例(114足),根据不同手术方式分为对照组52例(59足)行Juvara截骨术,联合组51例(55足)行Akin截骨术联合juvara截骨术。比较两组临床治疗优良率,治疗前后足踝功能拇外翻角(HVA)、第Ⅰ、Ⅱ跖骨间角(IMA)、第1跖骨远关节面角(DMAA)变化和影像学指标,统计术后并发症。结果 联合组优良率高于对照组,术后并发症发生率低于对照组(P<0.05)。术后3个月,联合组AOFAS评分高于对照组,HVA、IMA、DMAA角度小于对照组(P<0.05)。结论 中重度HV畸形患者行Akin联合Juvara截骨术治疗,对缩小HVA、IMA、DMAA角度、改善患者足踝功能的效果更显著,手术矫正效果更佳,且安全性较高。
Objective To explore the effect and safety of Akin osteotomy combined with first metatarsal basilar osteotomy(Juvara osteotomy) in the treatment of moderate to severe hallux valgus(HV) deformity.Methods A total of 103 patients(114 feet) with moderate to severe HV deformity undergoing osteotomy in our hospital were enrolled from January 2019 to December 2021. According to different surgical methods, the patients were divided into a control group(n=52, 59 feet) and a combination group(n=51, 55 feet). The control group was treated with Juvara osteotomy while the combination group was treated with Akin osteotomy combined with Juvara osteotomy. The good rate of clinical effect, the changes in ankle function, hallux valgus angle(HVA), I-II intermetatarsal angle(IMA), distal metatarsal articular angel(DMAA) of the first metatarsal bone and the imaging indicators were compared before and after treatment between the two groups. The postoperative complications were statistically analyzed.Results The good rate was higher, and incidence of postoperative complications was lower in the combination group than those in the control group(P<0.05). After 3 months of surgery, AOFAS score in the combination group was higher than that in the control group, and the angles of HVA, IMA and DMAA were lower than those in the control group(P<0.05).Conclusions Akin combined with Juvara osteotomy can significantly reduce the angles of HVA, IMA and DMAA, and improve the ankle function in patients with moderate to severe HV deformity. It has better surgical correction effect and higher safety.
作者
黄丽先
董红
彭琪
何月
尹诗九
HUANG Li-xian;DONG Hong;PENG Qi;HE Yue;YIN Shi-jiu(Department of Orthopedics,Shangjin Nanfu Hospital,Chengdu 611730,China)
出处
《实用医院临床杂志》
2022年第6期75-78,共4页
Practical Journal of Clinical Medicine
关键词
中重度拇外翻畸形
Akin截骨术
第一跖骨基底截骨术
足踝功能
Moderate and severe hallux valgus deformity
Akin osteotomy
First metatarsal basilar osteotomy
Ankle function
