摘要
目的:探究Scarf截骨术与第一跖骨双平面截骨术(Double metatarsal osteotomy,DMO)矫正中重度拇外翻畸形的疗效。方法:随机选取2020年4月-2022年4月于笔者医院就诊且接受DMO治疗的47例中重度拇外翻畸形患者(63患足)纳入对照组,随机选取同期接受Scarf截骨术治疗的51例中重度拇外翻畸形患者(67患足)纳入观察组进行回顾性分析。比较两组患者部分负重和完全负重的时间,评估其术前和术后1个月关节功能[美国足踝协会(American orthopedic foot and ankle society,AOFAS)评分]、形态学指标[拇外翻角(Hallux valgus angle,HVA)、第一跖骨相对长度(Relative length of first metatarsal,RLFM)、第一、二跖骨间角(Intermetatarsal angle,IMA)、关节面固有角(Distal metatarsal articular angle,DMAA)]、疼痛情况[视觉模拟评分(Visual analogue scale,VAS)]的变化,记录两组术后并发症发生情况。结果:观察组部分、完全负重时间显著短于对照组(P<0.05);术后1个月,观察组AOFAS评分、DMAA均显著优于对照组(P<0.05),RLFM、IMA、HVA两组比较差异均无统计学意义(P>0.05);两组术后1个月VAS均明显降低,且观察组低于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:Scarf截骨术与DMO均能有效治疗中重度拇外翻畸形,两者形态学改善情况相近,Scarf截骨后能显著缩短患者功能恢复时间。
Objective To explore the efficacy of Scarf osteotomy and double metatarsal osteotomy(DMO)on joint function and affected limb morphology of moderate-to-severe hallux valgus deformity.Methods 47 patients(63 feet)with moderate and severe hallux valgus deformity who were treated in the author's hospital from April 2020 to April 2022 were randomly selected as the control group,and 51 patients(67 feet)with moderate and severe hallux valgus deformity who were treated with Scarf osteotomy during the same period were randomly selected as the observation group for retrospective analysis.The partial weight-bearing time and full weight-bearing time were compared between the two groups of patients.The changes in joint function[American orthopedic foot and ankle society(AOFAS)],morphological indicators[hallux valgus angle(HVA),relative length of first metatarsal(RLFM),intermetatarsal angle(IMA),distal metatarsal articular angle(DMAA)]and pain[visual analogue scale(VAS)]were evaluated before treatment and after 1 month of treatment.The occurrence of postoperative complications was recorded in both groups.Results The partial weight-bearing time and full weight-bearing time in observation group were significantly shorter than those in control group(P<0.05).After 1 month of treatment,AOFAS and DMAA in observation group were significantly better than those in control group(P<0.05),but there were no significant differences in RLFM,IMA and HVA between both groups(P>0.05).VAS score in both groups was decreased significantly after 1 month of treatment,and the score in observation group was lower compared to control group(P<0.05).There was no statistical significance in the incidence rate of complications between the two groups(P>0.05).Conclusion Scarf osteotomy and DMO can both effectively treat patients with moderate-to-severe hallux valgus deformity,and have similar morphological improvement,and Scarf osteotomy can significantly shorten the functional recovery time.
作者
张丽丹
任毅
彭琪
梁晓艳
ZHANG Lidan;REN Yi;PENG Qi;LIANG Xiaoyan(Department of Orthopaedics,Shangjin Nanfu Hospital,Chengdu 611700,Sichuan,China;Department of Orthopaedics,West China Hospital,Sichuan University,Chengdu 610041,Sichuan,China)
出处
《中国美容医学》
CAS
2024年第11期125-128,共4页
Chinese Journal of Aesthetic Medicine
关键词
Scarf截骨术
第一跖骨双平面截骨术
中重度拇外翻
美国足踝协会评分
scarf osteotomy
double metatarsal osteotomy
moderate-to-severe hallux valgus
American orthopedic foot and ankle society score
