Peterson D A, Zilberfarb J L, Greene M A, Colgrove R C
Department of Orthopedics, Naval Medical Center, San Diego, California 92134-5000.
Foot Ankle Int. 1994 Feb;15(2):59-63. doi: 10.1177/107110079401500201.
The incidence of avascular necrosis of the metatarsal head following distal first metatarsal osteotomy combined with adductor tendon release has not been documented in a large series of patients. Of 82 consecutive procedures in 64 patients performed between 1986 and 1988, 42 patients (58 procedures) were available for clinical and radiographic examination. Average follow-up was 2.5 years (range 1.0-4.2 years). There were 35 L-shaped and 23 chevron osteotomies which were combined with a lateral soft tissue release that included adductor tenotomy. Preoperative hallux valgus angle averaged 25 degrees (range 15-40 degrees), and intermetatarsal angle averaged 12 degrees (range 5-24 degrees). Follow-up amount of correction averaged 13 degrees and 5 degrees, respectively. Eighty-four percent of patients were satisfied with their result. There was one case of avascular necrosis. The patient was asymptomatic at 4.2 years' follow-up, and the remaining patients included two with infections, one hallux varus, and no nonunions.
在一系列大量患者中，尚未记录到第一跖骨远端截骨术联合内收肌腱松解术后跖骨头缺血性坏死的发生率。在1986年至1988年间对64例患者连续进行的82例手术中，42例患者（58例手术）可进行临床和影像学检查。平均随访时间为2.5年（范围1.0 - 4.2年）。有35例L形截骨和23例V形截骨，均联合外侧软组织松解，包括内收肌腱切断术。术前拇外翻角平均为25度（范围15 - 40度），跖间角平均为12度（范围5 - 24度）。随访时矫正量平均分别为13度和5度。84%的患者对其结果满意。有1例缺血性坏死病例。该患者在4.2年随访时无症状，其余患者包括2例感染、1例拇内翻，无骨不连病例。
