摘要
目的：探讨 Silver 手术联合 Akin 截骨术治疗足拇外翻老年患者的临床疗效。方法选取2010年1月至2012年12月收治的足拇外翻老年患者40例。给予 Silver 手术联合 Akin 截骨术治疗，术后不采用外固定，尽早下床功能锻炼。随访并观察统计患者外翻角（HVA）、跖间角（IMA）和近侧关节固定角（PASA）的变化，疗效客观评价采用美国足踝外科协会（AOFAS）评分系统，采用自制调查表进行满意度调查。结果术前 HVA（29.65±4.79）°，术后矫正到（10.41±3.37）°，差异有统计学意义（t =27.47，P ﹤0.01），术前 IMA（9.47±2.48）°，术后矫正到（8.37±2.58）°，差异有统计学意义（t =3.21，P ﹤0.05）。术前 AOFAS 评分（28.37±5.81）术后提高到（82.74±10.76），具有统计学意义（t =35.71，P ﹤0.05）。结论 Silver 手术联合 Akin 截骨术治疗轻中度足拇外翻老年患者，矫正效果佳、复发率低，同时因不需要外固定，术后允许早期负重锻炼，可有效降低老年人围术期并发症发生率。
Objective To investigate the clinical curative effect of Silver operation combined with Akin osteotomy on elderly hallux valgus. Methods Forty cases of elderly hallux valgus patients from January 2010 to December 2012 were selected. All of the patients were given Silver operation com-bined with Akin osteotomy surgery treatment,with no external fixation after operation,and they all took functional exercise as soon as possible. The hallux valgus angle（HVA）,intermetatarsal angle（IMA） and proximal articular set angle（PASA）were followed - up and observed. The curative effect was evalu-ated objectively by the American Orthopaedic Foot and Ankle Society（AOFAS）scoring system,and self-designed questionnaire was used for satisfaction survey. Results HVA was（29. 65 ± 4. 79）° before op-eration and it was corrected to the（10. 41 ± 3. 37）°after operation,there was significant difference（t =27. 47,P ﹤ 0. 05）. IMA was（9. 47 ± 2. 48）° before operation and it was corrected to the（8. 37 ± 2. 58）°,there was significant difference（ t = 3. 21,P ﹤ 0. 05 ）. Pre-operative AOFAS score was （28. 37 ± 5. 81）and it was corrected to the（82. 74 ± 10. 76）after operation,there was significant differ-ence（t = 35. 71,P ﹤ 0. 05）. Conclusions Silver operation combined with Akin osteotomy has good correction effect on treatment of the elderly mild-to-moderate hallux valgus with low recurrence rate,be-cause of not need external fixation and allows early weight-bearing exercise,which can effectively reduce the incidence of perioperative complications.
出处
《中国实用医刊》
2014年第20期25-27,共3页
Chinese Journal of Practical Medicine
关键词
足拇外翻
手术
疗效
老年
Hallux valgus
Surgery
Curative effect
The elderly
