Fadel G E, Hussain S M, Sripada S, Jain A S
Department of Orthopaedics & Trauma, Ninewells Hospital & Medical School, Dundee, UK.
Foot Ankle Surg. 2008;14(1):21-5. doi: 10.1016/j.fas.2007.09.001. Epub 2007 Dec 11.
The purpose of this study is to determine clinical and radiological outcome following the internal fixation of first metatarsal basal osteotomy using Acutrak screw.
Between May 1999 and December 2003, 37 feet undergoing basal closing wedge osteotomy were stabilised using Acutrak screw. The minimum follow-up period was 18 months. The position and fate of the screw, complications, hallux valgus, intermetatarsal and metatarsal declination angles, and time for bony union were assessed postoperatively and at the final follow-up.
Seventy-nine percent of the corrected feet had achieved excellent or good AOFAS score, 13% fair, and 8% poor score. The average preoperative intermetatarsal, hallux valgus and first metatarsal declination angles were 17.3 degrees (12-20 degrees), 38 degrees (17-53 degrees) and 22.5 degrees (16-30 degrees), respectively. These were reduced to 10.3 degrees (0-16 degrees), 14.6 degrees (9-26 degrees) and 20.4 degrees (16-26 degrees) following surgery and 11.2 degrees (0-18 degrees), 16.0 degrees (12-22 degrees) and 20.1 degrees (16-23 degrees), respectively, at the final follow-up. Clinical and radiological union has been achieved in all cases.
Our technique provides stable fixation with minimal loss of position at the osteotomy site.
本研究的目的是确定使用Acutrak螺钉对第一跖骨基底截骨进行内固定后的临床和影像学结果。
1999年5月至2003年12月期间，对37只接受基底闭合楔形截骨的足部使用Acutrak螺钉进行固定。最短随访期为18个月。术后及末次随访时评估螺钉的位置和转归、并发症、拇外翻、跖间角和跖骨倾斜角以及骨愈合时间。
矫正后的足部中，79%的AOFAS评分达到优或良，13%为中等，8%为差。术前平均跖间角、拇外翻角和第一跖骨倾斜角分别为17.3度（12 - 20度）、38度（17 - 53度）和22.5度（16 - 30度）。术后这些角度分别降至10.3度（0 - 16度）、14.6度（9 - 26度）和20.4度（16 - 26度），末次随访时分别为11.2度（0 - 18度）、16.0度（12 - 22度）和20.1度（16 - 23度）。所有病例均实现了临床和影像学愈合。
我们的技术提供了稳定的固定，截骨部位位置丢失最小。
