微创Juvara联合Akin截骨术治疗重度母外翻的临床疗效研究

目的 探讨微创Juvara联合Akin截骨术治疗重度母外翻的临床疗效。 方法　选取2016年8月~ 2018年8月佛山市中医院骨八科治疗的重度母外翻患者45例（50足），均采用微创Juvara联合Akin截骨术。术前、术后3个月、6个月、12个月均通过X线片测量母外翻角、跖骨间角、跖骨远端关节角、跖趾关节远端固定角、趾骨间角，参照美国足踝外科协会（AOFAS）评分和Olerud-Molander主观功能（OMA）评分标准进行测评。 结果　45例患者术后均获随访，随访时间12 ~ 17个月，平均（14.20 ± 1.55）个月，无复发病例。上述指标及评分方面，术前与术后3个月、6个月、12个月相比，差异均具有显著性意义（P<0.01）；术后3个月、6个月和12个月两两比较，差异均无显著性意义（P>0.01）。 结论 微创Juvara联合Akin截骨术治疗重度母外翻疗效确切，手术切口小，安全性高，值得临床推广应用。

Clinical efficacy of minimally Juvara combined with Akin osteotomy on severe hallux valgus

Objective　To study the clinical efficacy of minimally Juvara combined with Akin osteotomy on severe hallux valgus.　Methods　Forty-five patients (50 feet) with severe hallux valgus treated by minimally Juvara combined with Akin osteotomy in Eight Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine from August 2016 to August 2018 were collected in this study. Hallux valgus Angle (HVA), intermetatarsal angle (IMA), distal metatarsal angle (DMAA), distal metatarsophalangeal angle (DASA), interphalangeal angle (IPA) were measured by X-ray examination preoperatively and 3, 6 and 12 months after operation. The efficacy was evaluated in accordance with the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Olerud-Molander Ankle (OMA) Score. Results All patients were followed up within 12～17 months (mean, 14.20±1.55 months). There was no recurrence during follow-up period. In terms of HVA, IMA, DMAA, DASA, IPA, AOFAS and OMA, there were significant differences in postoperative 3, 6 and 12 months and before operation (P<0.01). There were no significant differences among before operation and 3, 6 and 12 months postoperatively (P>0.01).　Conclusions　For severe hallux valgus, minimally Juvara combined with Akin osteotomy can effectively correct the hallux valgus deformity with small surgical incision, high safety and curative effect, which is worthy of popularization and application in clinical.