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克莱顿术后跖趾关节切除成形术(10年临床经验)(作者译)

[Resection arthroplasty of the metatarsophalangeal joints after Clayton (10 years of clinical experience) (author's transl)].

作者信息

Hehne H J

出版信息

Z Orthop Ihre Grenzgeb. 1977 Dec;115(6):897-906.

PMID:74919
Abstract

57 resection arthroplasties of the metatarsophalangeal joints using the method of Clayton were performed in arthritic and arthrotic deformities of the forefoot. 43 feet were controlled after an average of 5 years postoperatively. The good postoperative position of the toes changes into a progressive shortening, dorsal transposition and frequently valgus direction of the toes during the first year after operation. The deformity is much less than preoperatively. Passive mobility is good, but there is little active motion. The splay foot deformity is reduced in 50% of the cases. No arthritic recurrences were observed, callosities, clavi and mild pain were rarely found. Foot movements, walking ability was improved in all patients and 50% were wearing standard shoes. The results are influenced negatively by errors in resection technique, particularly lack of plantar rounding, exaggerated resection and unfavourable differencies in length of the metatarsal bones, and occasionally by secondary ossifications.

摘要

采用克莱顿(Clayton)方法对57例跖趾关节进行了切除关节成形术,用于治疗前足的关节炎和关节病畸形。术后平均5年对43只脚进行了随访。术后脚趾的良好位置在术后第一年逐渐转变为脚趾缩短、背侧移位,且常常出现外翻。畸形程度比术前轻得多。被动活动良好,但主动活动较少。50%的病例中扁平足畸形有所减轻。未观察到关节炎复发,胼胝、鸡眼和轻度疼痛很少见。所有患者的足部活动和行走能力均有所改善,50%的患者能够穿标准鞋子。手术技术失误,特别是跖侧未修成圆形、切除过多以及跖骨长度差异不利,偶尔还有继发性骨化,会对结果产生负面影响。

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