Chen Xue-Qiang, Wu Qun-Feng, Dong Wei-Qin, Yu Li-Xin, Li Xiong-Feng
Department of Foot and Ankle, the Central Hospital of Huzhou, Huzhou 313000, Zhejiang, China;
Zhongguo Gu Shang. 2018 Mar 25;31(3):213-216. doi: 10.3969/j.issn.1003-0034.2018.03.004.
To explore clinical effect of modified Chevron osteotomy combined with lateral tissue loosening for the treatment of mild-moderate hallux valgus through internal signal approach.
From July 2015 to June 2016, 26 patients with mild-moderate hallux valgus treated with modified Chevron osteotomy combined with lateral tissue loosening through internal signal approach, including 2 males and 24 females aged from 45 to 65 years old with an average of(54.6±4.8) years old;the courses of diseases ranged from 1 to 5 months with an average of (7.5±3.3) months. Hallux valgus angle(HVA), inter metatarsal angle(IMA) were measured at 12 months after operation, and AOFAS score was applied to evaluate clinical effect before and after operation.
All incisions were healed at stage I. No incision occurred infection, metatarsal necrosis and recurrence of hallux valgus deformity. Two patients occurred skin numbness caused by musculocutaneous nerve injury. Twenty-six patients were followed up from 6 to 12 months with an average of(9.12±2.06) months. HVA, IMA were(30.01±3.71)°, (14.00±1.50)° before operation and(9.41±4.16)°, (7.00±0.60)° after operation, which had significant difference. There was statistical significance in AOFAS score before operation 54.77±9.59 and after operation 92.73±5.47, and 19 cases obtained excellent results and 7 moderate.
Modified Chevron osteotomy combined with full thread headless pressure screw fixation and lateral tissue loosening for the treatment of mild-moderate hallux valgus has advantages of excellent exposure, simple operation, stable fixation, rapid recovery. Akin osteotomy with internal capsulorrhaphy were used with lateral loosening and could recover soft tissue balance between lateral and internal, and could receive satisfied clinical effects.
探讨改良Chevron截骨术联合外侧软组织松解经内侧入路治疗轻中度拇外翻的临床效果。
2015年7月至2016年6月,对26例轻中度拇外翻患者采用改良Chevron截骨术联合外侧软组织松解经内侧入路治疗,其中男性2例,女性24例,年龄45~65岁,平均(54.6±4.8)岁;病程1~5个月,平均(7.5±3.3)个月。术后12个月测量拇外翻角(HVA)、第1、2跖骨间夹角(IMA),并采用美国足与踝关节协会(AOFAS)评分评估手术前后临床疗效。
所有切口均Ⅰ期愈合,未发生切口感染、跖骨头坏死及拇外翻畸形复发。2例患者出现肌皮神经损伤导致的皮肤麻木。26例患者随访6~12个月,平均(9.12±2.06)个月。术前HVA、IMA分别为(30.01±3.71)°、(14.00±1.50)°,术后分别为(9.41±4.16)°、(7.00±0.60)°,差异有统计学意义。术前AOFAS评分为54.77±9.59,术后为92.73±5.47,差异有统计学意义;优19例,良7例。
改良Chevron截骨术联合全螺纹无头加压螺钉固定及外侧软组织松解治疗轻中度拇外翻具有显露好、操作简单、固定稳定、恢复快等优点。采用Akin截骨联合内侧关节囊缝合加外侧松解,可恢复内外侧软组织平衡,临床效果满意。