用于中重度拇外翻的斯卡夫截骨术和阿金截骨术：临床及影像学结果

Scarf and Akin osteotomies for moderate and severe hallux valgus: clinical and radiographic results.

作者信息

Garrido Ignacio Martínez, Rubio Eduardo Rodríguez-Vellando, Bosch Marta Navarro, González María Sánchez, Paz Guillermo Bastida, Llabrés Alfredo Juan

机构信息

Department of Orthopaedics, La Fe Hospital, University of Valencia, Valencia, Spain.

出版信息

Foot Ankle Surg. 2008;14(4):194-203. doi: 10.1016/j.fas.2008.02.003. Epub 2008 Jun 2.

DOI:10.1016/j.fas.2008.02.003

PMID:19083642

Abstract

BACKGROUND

The scarf and the combined scarf-Akin procedures are reliable therapeutic tools and can obtain effective correction of symptomatic moderate to severe hallux valgus deformities.

METHODS

The data from 30 patients (37 feet) with moderate to severe hallux valgus deformity who had scarf osteotomies have been retrospectively reviewed. 32 Akin and 77 Weil osteotomies were also carried out at the same stage. The average follow-up was 22 months. Standardized methods of radiographic and clinical data collection were obtained before and after surgery. Patient satisfaction was assessed at follow-up.

RESULTS

Radiological assessment revealed a significant improvement (p<0.001) of the hallux valgus angle (mean reduction 17.4 degrees), the intermetatarsal angle (mean reduction 5.8 degrees), the medial sesamoid position (14% of the feet were grade 1 or less preoperatively and this rate increased to 84% at follow-up) and the DMAA (mean reduction 9 degrees). The complication rate was 19%. Clinical improvement was achieved with the AOFAS score increasing from 46 to 86 points (p<0.001).

CONCLUSIONS

We conclude that the procedure has value in obtaining predictable correction of moderate to severe hallux valgus deformities.

摘要

背景

叠瓦状截骨术及联合叠瓦状 - Akin截骨术是可靠的治疗手段，能够有效矫正有症状的中重度拇外翻畸形。

方法

回顾性分析30例（37足）接受叠瓦状截骨术的中重度拇外翻畸形患者的数据。同期还进行了32例Akin截骨术和77例Weil截骨术。平均随访22个月。术前和术后采用标准化方法收集影像学和临床数据。随访时评估患者满意度。

结果

影像学评估显示拇外翻角（平均减小17.4度）、跖间角（平均减小5.8度）、内侧籽骨位置（术前14%的足为1级或更低级别，随访时该比例增至84%）和DMAA（平均减小9度）均有显著改善（p<0.001）。并发症发生率为19%。临床症状改善，美国足踝外科协会（AOFAS）评分从46分提高至86分（p<0.001）。