摘要
目的分析改良Scarf截骨在中、重度拇外翻个体化治疗中的应用效果。方法2015年2月至2017年6月,郑州市骨科医院微创骨科通过对拇外翻患者个体化评估,采用改良Scarf截骨治疗中、重度拇外翻患者79例130足;双足51例,单足28例。术前、术后1年根据美国足踝外科学会评分(AOFAS)标准及手术前后根据X线片测量拇外翻角(HVA)、跖骨间角(IMA)及跖骨远端关节角(DMAA)进行疗效评定。结果所有79例均获得随访,随访时间12~18(15.0±2.9)个月;所有手术均无切口感染、不愈合等并发症;截骨处未出现不愈合,愈合时间8~12(9.0±2.4)周;未出现医源性拇内翻及术后第1跖骨头坏死。疗效评定为优108足、良18足、可4足,治疗优良率96.92%。所有患者术后1年HVA(11.2±2.9)°、IMA(7.0±1.2)°及DMAA(7.5±2.9)°较术前明显改善HVA(41.4±7.2)°、IMA(19.7±4.1)°、DMAA(21.3±8.6)°,均P<0.05;AOFAS术后1年评分较术前明显升高,差异有统计学意义(91.1±4.3)分比(47.7±4.4)分,P<0.05。结论改良Scarf截骨个体化治疗中、重度拇外翻可取得满意的效果,安全性高,值得推广。
Objective To analyze the effect of modified Scarf osteotomy in the individualized treatment of hallux valgus.Methods From February 2015 to June 2017,the patients with severe and moderate bunion,79 cases of 130 feet,51 cases of bipod and 28 cases of single foot,were treated by modified Scarf osteotomy in Department of Minimally Invasive Orthopedics,Zhengzhou Orthopedics Hospital.The curative effect was evaluated individualized according to AOFAS score standard of American Academy of Foot and Ankle Surgery and imaging findings before and after operation.Results All 79 cases were followed up for 12-18(15±2.9)months on average.No complications such as wound infection and nonunion occurred in all operations.No nonunion occurred at the osteotomy site.The healing time was 8-12(9.0±2.4)weeks on average.No iatrogenic hallux varus and the first metatarsal head necrosis occurred after operation.The result of curative effect evaluation:108 were excellent,18 were good and 4 were fair.The excellent and good rate of treatment was 96.92%.HVA(11.2±2.9)°,IMA(7.0±1.2)°and DMAA(7.5±2.9)°in all patients 1 year after operation were significantly lower than those before operation HVA(41.4±7.2)°,IMA(19.7±4.1)°,DMAA(21.3±8.6)°(P<0.05);AOFAS(91.1±4.3)score was significantly higher than that before operation(47.7±4.4)score.The difference was statistically significant(P<0.05).Conclusion Modified Scarf osteotomy individualized treatment of moderate and severe hallux valgus can achieve satisfactory results,high safety.
作者
李翔
燕冰
赵士君
张威
Li Xiang;Yan Bing;Zhao Shijun;Zhang Wei(Department of Minimally Invasive Orthopedics, Zhengzhou Orthopedics Hospital, Zhengzhou 450000, China)
出处
《骨科临床与研究杂志》
2020年第6期355-359,共5页
Journal Of Clinical Orthopedics And Research
关键词
拇外翻
畸形
Scarf截骨
Hallux valgus
Abnormality
Scarf osteotomy Modified
