比较中度至重度拇外翻的近侧和远侧跖骨切开术。
Comparing proximal and distal metatarsal osteotomy for moderate to severe hallux valgus.
机构信息
Orthopaedic Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Int Orthop. 2012 Nov;36(11):2275-8. doi: 10.1007/s00264-012-1656-9. Epub 2012 Sep 19.
PURPOSE
This study compared results of distal and proximal metatarsal osteotomy for moderate to severe hallux valgus in terms of radiographic correction and functional outcome.
METHODS
We analyzed 125 moderate to severe hallux valgus surgeries. Patients were divided into two groups. Group 1 underwent distal metatarsal osteotomy, and group 2 underwent proximal metatarsal osteotomy. Patients were interviewed for functional scores before and one year after surgery. The anteroposterior (AP) weight-bearing radiography of the foot was taken before and one year after surgery.
RESULTS
There were no significant differences in pain and function after one year in either group. Both groups experienced significant pain reduction and increase in all functional scores. There was significant improvement of hallux valgus and intermetatarsal angle corrections in group 2. There was less improvement in radiographic correction in group 1.
CONCLUSION
Either distal or proximal metatarsal osteotomy is an appropriate pain-relieving procedure and can increase functional outcome in moderate to severe hallux valgus. However, distal metatarsal osteotomy provides lower correction power.
目的
本研究比较了中重度拇外翻的远侧和近侧跖骨切开术在放射学矫正和功能结果方面的效果。
方法
我们分析了 125 例中重度拇外翻手术。患者分为两组。组 1 行远侧跖骨切开术，组 2 行近侧跖骨切开术。术前和术后 1 年对患者进行功能评分访谈。术前和术后 1 年拍摄足部前后位（AP）负重位 X 线片。
结果
两组患者术后 1 年均无明显疼痛和功能差异。两组患者的疼痛均明显减轻，所有功能评分均明显增加。组 2 的拇外翻和跖间角矫正均有显著改善。组 1 的影像学矫正改善程度较低。
结论
远侧或近侧跖骨切开术都是一种缓解疼痛的有效方法，可以提高中重度拇外翻的功能结果。然而，远侧跖骨切开术提供的矫正力较低。
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