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经关节外侧松解联合远端楔形骨切开术治疗拇外翻

Hallux valgus correction using transarticular lateral release with distal chevron osteotomy.

机构信息

CHA Bandang Medical Center, CHA University, Seoul, Korea.

出版信息

Foot Ankle Int. 2012 Oct;33(10):838-43. doi: 10.3113/FAI.2012.0838.

Abstract

BACKGROUND

Transarticular lateral release through a medial incision can avoid a dorsal incision. This study investigated outcomes following hallux valgus correction using transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision.

METHODS

Between June 2004 and May 2009, a single surgeon performed a transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision for hallux valgus on a total of 103 feet of 68 patients. The average patient age at the time of surgery was 51 years, and the average followup was 27 months.

RESULTS

The average preoperative and final followup results were: 1) hallux valgus angle improvement from 29 degrees to 5 degrees, 2) intermetatarsal angle from 13 degrees to 5 degrees and 3) medial sesamoid bone position from 3 to 1 (p < 0.05 for each variable). The average AOFAS scores were improved from 49 to 92, and the VAS pain scores were improved from 7 to 1 (p < 0.05 for both variables). No patient had a serious complication such as infection, avascular necrosis, nonunion, transfer-metatarsalgia, or first metatarsophalangeal joint arthritis.

CONCLUSION

Hallux valgus correction using transarticular lateral release, distal chevron metatarsal osteotomy and Akin phalangeal osteotomy through one medial incision was found to be effective and safe. The advantages include that the procedure is simple, early ambulation is possible, and there is no dorsal scarring.

摘要

背景

经内侧切口行关节囊切开松解术可避免背侧切口。本研究通过单一内侧切口,探讨了经关节囊切开松解术、远端楔形跖骨截骨术和 Akin 趾骨截骨术治疗拇外翻的疗效。

方法

2004 年 6 月至 2009 年 5 月,一位外科医生对 68 例患者的 103 足拇外翻进行了单一内侧切口的经关节囊切开松解术、远端楔形跖骨截骨术和 Akin 趾骨截骨术。手术时患者的平均年龄为 51 岁,平均随访时间为 27 个月。

结果

术前和末次随访的平均结果为:1)拇外翻角由 29°改善至 5°,2)第 1、2 跖骨间角由 13°改善至 5°,3)内侧籽骨位置由 3 改善至 1(各变量差异均有统计学意义,p<0.05)。AOFAS 评分由 49 分提高至 92 分,VAS 疼痛评分由 7 分改善至 1 分(差异均有统计学意义,p<0.05)。无患者出现感染、骨坏死、骨折不愈合、转移性跖痛或第 1 跖趾关节骨关节炎等严重并发症。

结论

经单一内侧切口行关节囊切开松解术、远端楔形跖骨截骨术和 Akin 趾骨截骨术治疗拇外翻是有效且安全的。该术式的优点包括操作简单、可早期下地活动且无背侧瘢痕。

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