摘要
[目的]回顾分析Weil截骨治疗外翻转移性跖痛的疗效。[方法]自2004年至2005年联合应用第1跖骨基截骨及Weil截骨治疗伴有外侧跖骨头转移性跖痛的中重度外翻17例25足。患足手术前后常规拍摄足正侧位片,测量外翻角(HVA),I^II跖骨间角(IMA),使用美国足踝外科协会趾-跖趾-趾间关节评分系统(AOFAS)评分评估临床疗效。手术方法根据患者术前症状选择第1跖骨基底截骨联合外侧跖骨头Weil截骨。[结果]患者外翻角(HVA)术前为32°±5·7°,术后为12·8°±3·5°;I^II跖骨间角(IMA)术前为23·2°±3·7°,术后为10·5°±0·7°;AOFAS评分术前45·6±6·9分,术后86·9±4·6分;Weil截骨术后的跖骨短缩3~8mm,平均4·5mm;术后18足跖痛症状完全缓解,7例好转,所有患者日常生活正常,无需进一步治疗。[结论]外翻术前应综合分析足部的生物力学变化,对伴有外侧转移性跖痛的严重外翻患者,联合使用第1跖骨基截骨和外侧跖骨头Weil截骨可获得良好疗效。
[ Objective ] To evaluate the clinical result of W.eil osteotomy for refer metatarsalgia in hallux valgus. [ Method ] Between 2004 and 2005, 25 feet of 17 patients with hallux valgus were treated by osteotomy at the base of the first metatarsal and Weil osteotomy of the lesser metatarsal with metatarsalgia. Weight - bearing anterior - posterior and lateral X ray were taken before the surgery and 6 weeks after surgery on follow up. The hallux valgus angle , the intermetatarsal angle between 1st and 2nd metatarsal, and length of the second metatarsal were measured on the X - ray film. AOFAS system was used to judge the clinical result of the surgery. [ Result] The hallux valgus before surgery angle was 32°±5.7°, after surgery it was 12. 8°±3.5° ; the intermetatarsal angle between 1st and 2^nd metatarsal before surgery was 24. 2°±3.7° , after surgery it was 10. 5°±0.7°; AOFAS score was 45.6 ± 6.9 before surgery , and 86. 9 ± 4. 6 after surgery ; significant difference was found between the result. The metatarsal after Weil osteotomy was shorten by 3 - 8 mm, mean 4. 5 mm. After surgery 18 feet had pain free, and 7 feet had a signigicant pain relief. All the patient could return to normal life without other treatment. [ Conclusion ] The biomechanical changes in the foot with hallux valgus should be analyzed before surgery . Combined use of base osteotomy at the first metatarsal and Weil osteotomy at lesser metatarsal can get satisfactory clinical result in patients with sever hallux valgus and transferred refer metatarsalgia.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2008年第9期653-656,共4页
Orthopedic Journal of China
关键词
拇外翻
跖痛
Weil截骨
hallux valgus
metatarsalgia
Weil osteotomy
