Groulier P, Curvale G, Coillard J Y, Franceschi J P
Service de Chirurgie Orthopédique et Traumatologique, Hôpital de la Conception, Marseille.
Rev Chir Orthop Reparatrice Appar Mot. 1992;78(7):449-55.
The post operative iatrogenic hallux varus associates varus, big toe's dorsal flexion and supination. The pathogeny is dominated by musculo-tendinous lack of balance created by the initial operation and excessive exostosectomy. The authors have nineteen times surgically corrected this deformation. The procedure included in all cases, a medial arthrolysis; five times associated with a screwed capito-metatarsal osseous shelf (or graft) (when there was a metatarsal's head maiming); thirteen times associated with a metatarso-phalangeal arthrodesis (in cases of impaired joint surfaces). The authors analyse, besides, without excluding them the other surgical procedures for hallux varus, and particularly tendinous transfers. The results show the necessity of a perfect etiopathogenic analysis of the deformation.
术后医源性拇内翻合并内翻、拇趾背屈和旋后。其病因主要是初次手术造成的肌肉肌腱失衡以及过度的骨赘切除术。作者对这种畸形进行了19次手术矫正。该手术在所有病例中均包括内侧关节松解术;5次联合使用带螺纹的跖趾骨骨板(或植骨)(当存在跖骨头损伤时);13次联合跖趾关节融合术(在关节面受损的病例中)。此外,作者分析了拇内翻的其他手术方法,并不排除这些方法,尤其是肌腱转移术。结果表明对该畸形进行完善的病因分析是必要的。