改良Lapidus手术治疗伴有拇籽骨融合的重度拇外翻：一例报告
Severe Hallux Valgus With Coalition of the Hallux Sesamoids Treated With Modified Lapidus Procedure: A Case Report.
作者信息
Kurashige Toshinori, Suzuki Seiichi
机构信息
Department of Orthopaedic Surgery, Chiba Aiyukai Memorial Hospital, Nagareyama City, Chiba, Japan (TK).
Department of Orthopaedic Surgery, Mito Red Cross Hospital, Mito City, Ibaraki, Japan (SS).
出版信息
Foot Ankle Spec. 2017 Dec;10(6):567-571. doi: 10.1177/1938640017703187. Epub 2017 Apr 6.
UNLABELLED
Coalition of the hallux sesamoids is an extremely rare condition. To our knowledge, only 1 case report has been published. We report a case of severe hallux valgus deformities with coalitions of the hallux sesamoids. The coalitions themselves were asymptomatic; however, this severe hallux valgus deformity needed to be surgically treated. The hallux sesamoids in both feet appeared to be fused and heart shaped on anteroposterior radiographs and dumbbell shaped on axial radiographs. It is known that postoperative incomplete reduction of the medial sesamoids can be a risk factor for the recurrence of hallux valgus. The computed tomography scan demonstrated a groove in the bottom of the center of the heart-shaped sesamoid. The flexor hallucis longus tendon was located in the groove. Therefore, a modified Lapidus procedure was performed considering the medial half of the heart-shaped sesamoid as the medial sesamoid. Although delayed union occurred, successful correction of the deformity was achieved.
LEVELS OF EVIDENCE
Level IV.
未标注
拇趾籽骨联合是一种极其罕见的病症。据我们所知，仅发表过1例病例报告。我们报告1例伴有拇趾籽骨联合的重度拇外翻畸形病例。籽骨联合本身无症状；然而，这种重度拇外翻畸形需要手术治疗。双足的拇趾籽骨在前后位X线片上呈融合且心形，在轴位X线片上呈哑铃形。已知内侧籽骨术后复位不完全可能是拇外翻复发的危险因素。计算机断层扫描显示心形籽骨中心底部有一条沟。拇长屈肌腱位于该沟内。因此，考虑将心形籽骨的内侧半部分视为内侧籽骨，实施了改良Lapidus手术。尽管发生了延迟愈合，但成功矫正了畸形。
证据级别
四级。
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