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1.
(足,母)外翻合并第二跖骨头下疼痛的生物力学定量研究   总被引:6,自引:0,他引:6  
目的探讨跖骨头下压力变化与蹰外翻合并跖骨头下疼痛的关系,并对引起第二跖骨头下疼痛的跖骨头下压力进行定量分析。方法采用由中国中医研究院骨伤科研究所生物力学实验室研制的足底压力测试系统,对58名正常人(116足),32例(45足)拇外翻单纯合并第二跖骨头下疼痛患者,56例(102足)拇外翻无足底疼痛患者进行足底压力测试,将三组跖骨头下压力进行比较。采用病例一对照设计,研究压力与疼痛的关系,并对引起第二跖骨头下疼痛的压力进行定量分析。结果(1)蹲外翻单纯合并第二跖骨头下疼痛组分别与拇外翻无足底疼痛组及正常组比较,第二跖骨头下压力均明显增高(均P〈0.05);(2)第二跖骨头下压力高于正常组与第二跖骨头下压力不高于正常组比较,疼痛的发生率明显增加(P〈0.05,OR〉3,OR95%CI〉1);(3)拇外翻合并第二跖骨头下疼痛组第二跖骨头下压力占体重的5.20%-7.29%。结论跖骨头下压力异常增高是跖骨头下疼痛的危险因素,第二跖骨头下压力超过体重的5.20%,极易出现跖骨头下疼痛。  相似文献   

2.
外翻合并第二跖骨头下疼痛的生物力学定量研究   总被引:5,自引:0,他引:5  
目的探讨跖骨头下压力变化与(足,母)外翻合并跖骨头下疼痛的关系,并对引起第二跖骨头下疼痛的跖骨头下压力进行定量分析.方法采用由中国中医研究院骨伤科研究所生物力学实验室研制的足底压力测试系统,对58名正常人(116足),32例(45足)(足,母)外翻单纯合并第二跖骨头下疼痛患者,56例(102足)(足,母)外翻无足底疼痛患者进行足底压力测试,将三组跖骨头下压力进行比较.采用病例-对照设计,研究压力与疼痛的关系,并对引起第二跖骨头下疼痛的压力进行定量分析.结果 (1)(足,母)外翻单纯合并第二跖骨头下疼痛组分别与(足,母)外翻无足底疼痛组及正常组比较,第二跖骨头下压力均明显增高(均P<0.05);(2)第二跖骨头下压力高于正常组与第二跖骨头下压力不高于正常组比较,疼痛的发生率明显增加(P<0.05,OR>3,OR 95%CI>1);(3)(足,母)外翻合并第二跖骨头下疼痛组第二跖骨头下压力占体重的5.20%~7.29%.结论跖骨头下压力异常增高是跖骨头下疼痛的危险因素,第二跖骨头下压力超过体重的5.20%,极易出现跖骨头下疼痛.  相似文献   

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4.
目的探讨可吸收棒在拇外翻第1跖骨基底楔形截骨术中的应用疗效。方法对青中年中至重度拇外翻患者采用第1跖骨基底截骨结合拇趾骨赘切除、关节囊紧缩缝合 拇内收肌松解术,截骨端以可吸收棒交叉固定。结果53例(81足),随访3~16个月。采用美国足踝矫形学会拇外翻评分标准,平均HVA矫正17°,平均IMA矫正6°,优63足,良14足,差4足,优良率95%。结论截骨端采用可吸收棒交叉固定同金属螺钉相比能避免对软组织的刺激,安全有效,不需再次手术取出内固定。  相似文献   

5.
目的 回顾分析第一跖骨基底部截骨治疗足拇外翻的疗效.方法 采用第一跖骨基底部截骨钢板内固定、拇囊肿切除、拇内收肌切断、第一跖骨头骨赘切除治疗足拇外翻28例32足.结果 术后足拇外翻角、第一、二跖骨夹角、第一、五跖骨夹角均较术前有明显改善(P<0.05).术前AOFAS评分为(49.2±4.1)分,术后为(85.6±5.2)分;手术前后比较,差异均有统计学意义(P<0.05).结论 对于无第一跖趾关节骨关节炎的足拇外翻患者,应用上述方法治疗可以获得良好的效果.  相似文献   

6.
第一跖骨头部分截除术治疗拇外翻   总被引:1,自引:0,他引:1  
  相似文献   

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目的探讨McBride手术联合第1、2跖骨近端截骨治疗拇外翻的疗效。方法在McBride手术基础上,行第1跖骨近端的楔形外翻截骨和第2跖骨近端截骨,第1跖骨截骨处行微型钢板内固定,第2跖骨截骨处不做固定。术后石膏固定4周后即开始逐渐负重功能锻炼。结果26例均获随访,时间12~48个月。40足中优28足,良10足,差2足,优良率95%。与术前比较,拇外翻角平均矫正16.3&#176;&#177;2.2&#176;,第1、2跖骨间夹角平均矫正4.2&#176;&#177;1.8&#176;。无截骨处愈合不良、拇内翻、感染。结论McBride手术重建了足拇指的软组织力量平衡,第1、2跖骨截骨改善了第1跖骨的正常负重、缓解了第2跖骨头的压力,恢复足横弓,是治疗拇外翻的较好术式。  相似文献   

9.
目的 探究Scarf+Akin截骨术(Scarf Akin osteotomy, SAO)联合第1跖骨头下沉(the first metatarsal head was sunk, FMHS)治疗中重度(足母)外翻伴转移性跖骨痛的临床疗效。方法 2019年10月至2021年10月采用SAO联合FMHS治疗51例(62足)(足母)外翻患者,其中男性6例,女性45例;年龄26~69岁,平均(46.40±13.69)岁。分析比较术前及末次随访时患足负重正位X线片所示(足母)外翻角(hallux valgus angle, HVA)、跖骨间角(intermetatarsal angle, IMA)、跖骨远端关节面角(distal metatarsal articular angle, DMAA)及第1跖骨角(first metatarsal angle, FMA)等影像学结果的变化。采用美国足踝外科学会(American orthopedic foot and ankle society, AOFAS)(足母)指关节评分系统评价疗效。采用视觉模拟评分法(visual analogue scal...  相似文献   

10.
目的 :探讨第1跖骨远端Chevron截骨联合软组织松解术治疗轻、中度拇外翻的临床疗效。方法:自2015年6月至2017年6月,采用第1跖骨远端Chevron截骨联合软组织松解术治疗拇外翻32例(40足),其中男3例3足,女29例37足;年龄22~80岁,平均57.57岁;病程2~32年,平均14年;轻度9足,中度31足。术前患者合并拇囊炎,伴有第1跖趾关节周围疼痛并存在负重行走时疼痛加重。手术前后拍摄足负重正侧位片,比较拇外翻角(hallux valgus angle,HVA),第1、2跖骨间角(intermetatarsal angle,IMA),并采用美国足踝外科协会拇外翻评分(AOFAS)评价临床疗效。结果:32例患者获得了随访,时间12~24个月,平均15.2个月。术后切口均愈合良好,无感染、跖骨头坏死等并发症发生。术前HVA、IMA分别由(32.08±5.59)°、(11.63±2.24)°减小至术后12个月的(10.31±4.36)°、(5.02±2.34)°,差异有统计学意义(P0.05)。AOFAS评分由术前的56.75±6.42提高至术后12个月的88.80±3.99 (P0.05)。结论:第1跖骨远端Chevron截骨联合软组织松解术治疗轻、中度拇外翻畸形可获得较好的临床效果,为拇外翻治疗提供了更多的选择。  相似文献   

11.
目的回顾分析单纯第一跖骨及联合第二和(或)第三跖骨基底截骨治疗!外翻的疗效。方法1994年1月至2003年12月,采用单纯第一跖骨及联合第二和(或)第三跖骨基底截骨治疗!外翻,其中35例56足资料完整并获得随访。行第一跖骨基底截骨术26例43足,行第一跖骨及联合第二和(或)第三跖骨基底截骨术9例13足,患者第二和(或)第三跖骨头下存在疼痛性胼胝体。患足均于手术前、后摄负重正侧位X线片。结果行第一跖骨基底截骨术患者术前!外翻角为30.1°±4.9°,第一跖楔关节角为12.2°±5.0°;术后!外翻角为14.7°±2.7°,第一跖楔关节角为6.9°±1.5°。术前AOFAS评分为(47.6±5.8)分,术后为(84.3±5.7)分。行第一跖骨联合第二和(或)第三跖骨基底截骨术患者术前!外翻角为35.0°±5.8°,第一跖楔关节角为16.7°±1.8°;术后!外翻角为16.7°±2.4°,第一跖楔关节角为7.8°±1.4°。术前AOFAS评分为(44.7±5.7)分,术后为(85.7±4.5)分。在手术前、后X线片上测量相关解剖角度,并进行比较。!外翻角、第一跖楔关节角、第一、二跖骨间角、第一、五跖骨间角、近端关节固定角术后与术前相比,差异有统计学意义,远端关节固定角手术前、后未见明显变化。AOFAS评分手术前、后比较,差异有统计学意义。结论对于第一跖楔关节角增大的!外翻患者,应用第一跖骨基底截骨术矫正第一跖骨内收畸形可以获得优良的术后效果;而对于伴有前足疼痛性跖侧胼胝体者,建议联合行第二和(或)第三跖骨基底截骨术,以恢复正常的跖骨头平面足横弓。  相似文献   

12.
郑伟鑫  杨杰  李毅  梁晓军  王军虎  杜洋  王欣文 《中国骨伤》2022,35(12):1138-1141
目的:探讨旋转Scarf截骨术治疗拇外翻(hallux valgus,HV)合并第1跖骨旋转的临床疗效。方法:自2018年1月至2019年10月采用旋转Scarf截骨术治疗35例(40足)HV合并第1跖骨旋转畸形患者,其中男5例,女30例;年龄25~76(40.32±5.43)岁。观察并比较手术前后拇外翻角(hallux valgus angle,HVA),第1、2跖骨间角(intermetatarsal angle,IMA),第1跖骨远端关节面角(distal metatarsal articular angle,DMAA),第1跖骨长度(the first metatarsal length,FML),术后采用美国矫形骨科学会足踝外科学组(American Orthopedic Foot and Ankle Society,AOFAS)拇趾-跖趾-趾间关节评分和疼痛视觉模拟评分(visual analogue scale,VAS)系统进行功能评价。结果 :35例(40足)均获得随访,时间12~36(14.35±3.62)个月。HVA、IMA和DMAA分别由术前的(36.32±4.5...  相似文献   

13.

Background

Previous qualitative studies have linked first metatarsal head morphology with hallux valgus (HV) and hallux rigidus (HR). This study used a quantitative measurement of 1st MT radius of curvature to assess if HR MT heads were flatter than HV heads.

Methods

Weight bearing foot films were used in HV, HR, and normal patients (no forefoot complaints) to measure the metatarsal head radius of curvature (normalized by dividing the radius of curvature by the first metatarsal length to adjust for magnification and foot size).

Results

Radiographs from 299 feet were analyzed (105 normal, 57 HR, and 137 HV). The mean normalized radius of curvature was smaller in HV than HR, with normal feet in between (p < .05 for all comparisons). Metatarsal head curvature did not vary with age, weight, or BMI.

Conclusion

These quantitative measurements are consistent with qualitative observations, validating the use of subjective metatarsal head morphology assessments.  相似文献   

14.
Abstract Fifty moderate to severe hallux valgus deformities were corrected with a distal soft tissue realignment and proximal crescentic metatarsal osteotomy. With an average follow-up of 5.6 years, 40 feet (80%) were pain free and 42 (84%) caused no functional limitation. The average hallux valgus angle improved from 38.2° preoperatively to 12.4° at follow-up. The average intermetatarsal angle improved from 15.4° to 6.8°. The arch of motion of the first metatarsophalangeal joint was 75° preoperatively and 62° at follow-up. According to the AOFAS scoring system, 29 results (58%) were excellent, 14 (28%) good, 2 (4%) fair and 5 (10%) poor. The 5 poor results were attributed to recurrence of hallux valgus (2 cases), stiffness (1), hallux varus (1) and malunion of the osteotomy in dorsiflexion (1). The incidences of hallux varus and malunion in dorsiflexion were 8% and 14%, respectively. This technique is valuable in correction of moderate to severe hallux valgus deformities.  相似文献   

15.
Scarf截骨治疗中、重度(足母)外翻   总被引:1,自引:0,他引:1  
目的探讨Scarf截骨治疗拇外翻的手术适应证、手术方法及近期疗效。方法2001年1月至2005年12月,手术治疗拇外翻患者25例40足,其中23例36足获得随访,男2例2足,女21例34足;年龄28~70岁,平均56岁。手术均采用Scarf截骨,术中2枚螺钉固定。比较手术前、后及末次随访时与拇外翻相关的各角度的X线测量值,并结合AOFAS和VAS评分观察疗效。术前、术后的各组数据采用SPSS 11.5统计软件进行统计学分析。结果拇外翻角和第一、二跖骨间角从术前的38.0°±22.0°和16.0°±4.6°改善到术后的14.0°±6.1°和7.8°±2.9°,第一跖骨远端关节面角从23.0°±15.0°矫正为7.7°±5.1°。末次随访时拇外翻角为15.0°±5.7°,第一、二跖骨间角为8.8°±4.1°,第一跖骨远端关节面角为5.9°±3.8°。患者随访10-57个月,平均32个月。AOFAS评分从术前(46±17)分改善为(85±11)分,VAS评分从(7.4±2.3)分改善为(3.3±1.9)分。术后拇僵硬2例,最内侧皮神经损伤1例,转移性跖骨痛1例。结论Scarf截骨具有较好的自身稳定性,并发症少,手术效果好,可作为中、重度拇外翻矫形手术的首选方法。  相似文献   

16.
《Foot and Ankle Surgery》2021,27(8):892-896
BackgroundHallux valgus affects 23–36% in general populations. The purpose of this study was to evaluate return to run following either a modified Lapidus procedure or a metatarsal osteotomy. We hypothesized that there would be no difference in the ability to return to running.MethodsA Retrospective review of a consecutive series of patients at a single institution with surgical correction was performed. 51 patients were identified. 35 were treated with a metatarsal shaft osteotomy and 16 with a modified Lapidus.ResultsNo difference was found between the cohorts in terms of age, sex, or preoperative hallux valgus angle (HVA). 27/35 (77%) with metatarsal shaft osteotomy were able to return to running versus 13/16 (81%) with modified Lapidus. There was no significant difference in the ability to return to running between cohorts (p =1.00).ConclusionOur study showed no statistical difference for the modified Lapidus versus metatarsal osteotomies relative to return to running.  相似文献   

17.
BackgroundScarf osteotomy has been widely used to restore axial orientation of the first ray in the treatment of hallux valgus deformity. The aim of the study was to present our radiological outcomes of bunion reconstruction, identify surgical complications in early follow-up, and assess to what extent a shortening of the first metatarsal is present after surgery as a possible cause of postoperative metatarsalgia.MethodsWe enrolled 106 patients (118 feet) and assessed patients’ pre- and postoperative measurements of hallux valgus and intermetatarsal angles on weightbearing X-ray images. Three different methods of measuring metatarsal length were compared and early postoperative complications noted.ResultsHallux valgus angle decreased significantly by an average of 18.7 degrees and the intermetatarsal angle by 7.8 degrees. Using three methods of measuring metatarsal length, all showed significant shortening of the first metatarsal. Mean relative lengthening of the second metatarsal averaged 0.45 mm. The Coughlin method showed the highest interrater reliability (ICC = 0.96).ConclusionsSignificant reduction of the hallux valgus angle and intermetatarsal angle was demonstrated with a low complication rate. There was significant shortening of the first metatarsal. The Coughlin method clearly demonstrated an excellent interrater reliability.Level of evidenceLevel IV.  相似文献   

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