微创技术“裹帘”法外固定治疗拇外翻的临床分析

摘要

Objective:To evaluate the clinical efficacy of hallux valgus minimally invasive treatment combined with traditional Chinese medicine and western medicine based on “Wrapped Curtain” method external fixation.Method:Sixty-three cases(120 feet) of hallux valgus patients of our hospital from November 2014 to March 2015 were selected and treated by minimally invasive osteotomy manipulation,then they were followed up for an average of 9 months,the X-ray film,appearance,symptoms,joint function and imaging indicators were observed,the efficacy of patients after treatment were assessed by AOFAS(American Orthopaedic Foot &Ankle Society) and improved efficacy evaluation criteria made by Professor Wen Jian-min.Result:The HAV, IM,the width of the first metatarsophalangeal head,and AOFAS scores were better than which of preoperation, the differences were statistically significant(P<0.05),while the difference had no statistic significant on random motion of the first metatarsophalangeal joint before or after the operation(P>0.05).The excellent rate was 97.5%. Conclusion:Hallux valgus minimally invasive treatment combined with traditional Chinese medicine and western medicine based on “Wrapped Curtain” method external fixation is simple,convenient,which causes less pain and more effective,patients after the treatment have no complications,recover rapidly with no nonunion,which is the most effective method for the treatment of hallux valgus.%目的：评价中西医结合微创技术基于“裹帘”法外固定治疗拇外翻的临床疗效。方法：选择2014年11月-2015年3月本院收治的63例（120足）拇外翻患者，采用中国中医科学院望京医院温建民教授研发的中西医结合微创技术进行治疗，术后平均随访9个月，定期拍片复查，观察外观、自觉症状、关节功能及影像学相关指标。采用踝与后足功能评分（American Orthopaedic Foot & Ankle Society， AOFAS）标准及温建民教授改良的疗效评价标准对患者疗效进行评定。结果：患者术后拇外翻角（HAV）、第1、2跖骨间角（IM）、第1跖骨头宽度、AOFAS评分均较术前明显改善，比较差异均有统计学意义（P<0.05），第1跖趾关节活动度治疗前后差异无统计学意义（P>0.05）。患者治疗优良率为97.5%。结论：中西医结合微创技术基于“裹帘”法外固定治疗拇外翻术式简便有效，患者痛苦少，恢复快，无并发症，无骨折不愈合情况发生，是目前治疗拇趾外翻的理想方法。