老年性拇外翻的治疗

目的探讨老年性拇外翻的治疗方法。方法自2003年10月至2007年10月期间用第一跖趾关节融合术共治疗拇外翻足21例,患者年龄60-81岁,平均（66.13±6.8）岁。术前拇外翻角度平均47.0±5.4度,第一、二跖骨间夹角平均16.3±4.7度,术前按美国足踝外科拇趾跖趾关节-趾间关节评分标准评定,平均26.4±4.5分。全部病人均采用跖趾关节内侧切口,修整关节面后用二枚直径3.0mm空心钉固定。结果术后拇外翻角度平均16±6.5度,较术前平均减小29.3±3.5度（P〈0.01）;第一、二跖骨间夹角平均9.5±4.7度,较术前平均减小7.4±2.5度（P〈0.01）。术后按美国足踝外科拇趾跖趾-趾间关节评分标准评定,平均87.9±5.1分,平均提高65.1±4.7分（P〈0.01）。结论第一跖趾关节融合术可有效地治疗年龄大、畸形严重、骨质疏松以及跖趾关节骨关节炎的拇外翻。

Clinical treatment of hallux valgus in elderly

Objective To study and discuss the clinical treatment of hallux vallux in old people. Methods Metatarsophalangeai （MTP） arthrodesis of the great toe was used tor the treatment of hallux vallux in 21 old patients from October 2003 to October 2007. The mean age of the patients was 66.13 years （range 60-8 lyears）; the mean pre-operative HVA was 47.0± 5.4 degrees; the mean pre-operative IMA was 16.3±4.7 degrees; and the pre-operative Hallux MTP-IP Scale was 26.4 ± 4.5 points. A dorsal-medial incision was used for all the patients, and two 3.0mm crews across the articulation were used for fixation. Results Post-operative HVA was 16±6.5 degrees, with a decrease of 29.3±3.5 degrees（ P〈0.01 ）.Post-operative IMA was 9.5± 4.7 degrees, with a decrease of 7.4 ± 2.5 dgrees （P〈0.01）. Post-operative Hallux MTP-IP Scale was 87.9 ± 5.1 points, with an increase of 65.1± 4.7 points（ P〈0.01 ）. Conclusions MTP arthrodesis is an efteetive treatment for severe hallux valgus accompanied with osteaporosis or/and osteoarthritis in MP joint in old people.