Zhang Yingze, Zhang Fengqi, Han Jiuhui
Department of Foot and Ankle Surgery, the Third Hospital, Hebei Medical University, Shijiazhang Hebei, 050051, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Nov;21(11):1171-4.
To discuss the mechanisms and clinical effect of musculus extensor hallucis longus shifting in correcting hallux valgus (HV) deformity.
From April 2004 to December 2006, 25 cases of HV (38 feet) were treated by musculus extensor hallucis longus shifting. There were 2 men and 23 women, aging from 22-60 years (mean 46.3 years). HV angle was 21-45 degrees (mean 31.30 degrees), intermetatarsal (IM) angle was 7-21 degrees (mean 12.52 degrees). The HV were corrected by cutting osteophyma of the first metatarsal bone, cutting transverse head of adductor pollicis, transferring musculus extensor hallucis longus and reconstructing its insertion.
The patients were followed up 6-14 months after operation. HV angle and IM angle were 7.30 degrees +/- 2.62 degrees and 6.50 degrees +/- 2.46 degrees respectively, showing significant differences when compared with before operation (P < 0.05). According to the American Orthopaedic Foot & Ankle Society (AOFAS) score system, the foot function was excellent in 25 feet, good in 7 feet and poor in 6 feet, and the excellent and good rate was 84.2%. Hallux varus occurred in 2 feet after 2 months of operation, metatarsophalangeal joint limitation of motion in 2 feet after 3 months of operation, no HV recurred.
The HV deforemity can be corrected by shifting the musculus extensor hallucis longus and reconstructing its insertion. It makes stress of metatarsophalangeal joint balance and prevent recurrance of HV deformity.
探讨拇长伸肌移位矫正拇外翻(HV)畸形的机制及临床效果。
2004年4月至2006年12月,采用拇长伸肌移位治疗25例HV患者(38足)。其中男性2例,女性23例,年龄22 - 60岁(平均46.3岁)。HV角为21 - 45度(平均31.30度),第1、2跖骨间角(IM角)为7 - 21度(平均12.52度)。通过切除第1跖骨骨赘、切断拇收肌横头、移位拇长伸肌并重建其止点来矫正HV。
术后随访6 - 14个月。术后HV角和IM角分别为7.30度±2.62度和6.50度±2.46度,与术前比较差异有统计学意义(P < 0.05)。根据美国足踝外科协会(AOFAS)评分系统,足部功能优25足,良7足,差6足,优良率为84.2%。术后2个月有2足出现拇内翻,术后3个月有2足出现跖趾关节活动受限,无HV复发。
通过拇长伸肌移位并重建其止点可矫正HV畸形,使跖趾关节应力平衡,防止HV畸形复发。