[1]张威,赵士君,李翔,等.第一跖楔关节融合术联合Akin截骨术治疗重度外翻合并第一跖楔关节不稳[J].中医正骨,2021,33(12):58-61.
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第一跖楔关节融合术联合Akin截骨术治疗重度外翻合并第一跖楔关节不稳()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年12期
页码:
58-61
栏目:
临床报道
出版日期:
2021-12-20

文章信息/Info

作者:
张威; 赵士君; 李翔; 燕冰
(郑州市骨科医院,河南 郑州 450052)
关键词:
外翻;  跗关节;  关节融合术;  截骨术
摘要:
目的:探讨第一跖楔关节融合术联合Akin截骨术治疗重度外翻合并第一跖楔关节不稳的临床疗效和安全性。方法:2014年2月至2020年2月,采用第一跖楔关节融合术联合Akin截骨术治疗重度外翻合并第一跖楔关节不稳患者12例(19足)。均为女性,年龄46～72岁,中位数54岁。单侧5例,双侧7例。记录手术时间、术中出血量; 分别于术前、术后6周、末次随访时,测量外翻角(hallux valgus angle,HVA)和第一、第二跖骨间夹角(intermetatarsal angle,IMA),采用疼痛视觉模拟量表(visual analogue scale,VAS)、美国足与踝关节协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分标准、Maryland足部评分标准评价临床疗效; 随访观察并发症发生情况。结果:本组患者均顺利完成手术,手术时间(43.27±21.44)min,术中出血量(20.32±15.20)mL。所有患者均获随访,随访时间12～24个月,中位数16个月。HVA,术前42.26°±6.38°、术后6周9.14°±2.53°、末次随访时10.34°±2.26°; IMA,术前16.81°±3.56°、术后6周4.26°±2.18°、末次随访时5.72°±2.44°; 足部疼痛VAS评分,术前(5.25±2.11)分、术后6周(3.16±1.50)分、末次随访时(1.32±1.16)分; AOFAS踝与后足评分,术前(54.76±7.57)分、术后6周(78.26±7.12)分、末次随访时(89.42±6.24)分; Maryland足部评分,术前(60.26±5.65)分、术后6周(80.32±6.22)分、末次随访时(92.44±8.58)分。1例切口感染、延迟愈合,给予加强换药、烤灯持续照射后切口愈合; 1例趾背内侧局部皮肤感觉减退,给予口服甲钴胺片治疗后症状消失; 2例跖趾关节活动受限,给予中药薰洗并加强跖趾关节功能锻炼后跖趾关节活动正常; 1例转移性跖骨痛,但疼痛较轻,给予口服非甾体抗炎药对症治疗。均未发生截骨处延迟愈合、内固定松动或断裂、外翻复发等并发症。结论:采用第一跖楔关节融合术联合Akin截骨术治疗重度外翻合并第一跖楔关节不稳,能够矫正外翻畸形,缓解足部疼痛,有利于足部功能恢复,且安全性高。

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相似文献/References:

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　BI Chunqiang,WEN Jianmin,SANG Zhicheng,et al.X-ray study of the stability of osteotomy site after osteotomy and external fixation based on concept of“wrapped curtain”for treatment of hallux valgus[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(12):5.
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[6]周红星,宋书杰,姜祖康.Scarf联合Akin截骨术治疗重度外翻[J].中医正骨,2019,31(05):62.
[7]许文博,张峰,贺萍萍,等.改良Youngswick截骨术联合活血消肿汤口服治疗僵硬合并外翻[J].中医正骨,2020,32(09):70.
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　LI Xiang,YAN Bing,ZHAO Shijun,et al.Modified Scarf osteotomy combined with Chinese herbal steaming-washing for treatment of moderate-to-severe hallux valgus[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(12):69.
[9]陈思,温建民,孙卫东,等.外翻足底压力分析的研究进展[J].中医正骨,2024,36(04):66.

备注/Memo

备注/Memo:
通讯作者:燕冰 E-mail:yanb2009@sina.com
更新日期/Last Update: 1900-01-01