跖骨远端Chevron截骨结合关节囊松解治疗轻、中度拇外翻

摘要

目的 探讨跖骨远端Chevron截骨结合关节囊松解治疗轻、中度拇外翻的临床效果.方法 对32例患者(48足)行Chevron截骨手术治疗,测量手术前后拇趾外翻角(HVA),第1、2跖骨间夹角(IMA)的变化,评估足部疼痛及关节活动恢复情况.结果 29例(44足)获得随访,时间12~16(14.5±4.1)个月;3例(4足)失访.患者对术后临床效果满意,截骨部位愈合时间为4~6周.术前HVA为30°±4.1°、IMA为14°±1.7°;术后3个月HVA为4°±4.2°、IMA为10°±2.4°,术后1年HVA为5°±4.5°、IMA为11°±3.3°,均较术前明显减小,差异有统计学意义(P<0.05);术后1年与术后3个月的HVA、IMA比较差异无统计学意义(P>0.05).结论 跖骨远端Chevron截骨结合关节囊松解治疗轻、中度拇外翻疗效满意.%Objective To investigate the clinical effect of distal metatarsal Chevron osteotomy and release of joint capsule through medical approach in the treatment of mild or moderate hallux valgus.Methods Thirty-two patients (48 feet) with mild or moderate hallux valgus deformity were treated by modified Chevron osteotomy.The value of hallux valgus angle(HVA) and inter-metatarsus angle(IMA),the feet pain and joint movement before and after surgery were compared.Results The 29 patients were followed up for 12~16(14.5±4.1)months,3 cases(4 feet) were lost.The patients were satisfied with the postoperative clinical results and the osteotomy positions were healed in 4~6 weeks.The preoperative HVA and IMA were 30°±4.1°,14°±1.7°,respectively;and which were 4°±4.2°,10°±2.4° at 3 months postoperation;5°±4.5°,11°±3.3° at 1 year after operation,they were less than the preoperation,the difference was statistically significant (P<0.05);there were not statistically significant between the data of postoperative 3 months and 1 year (P>0.05).Conclusions Distal metatarsal Chevron osteotomy and transarticular lateral soft tissue release are effective methods for mild or moderate hallux valgus.