Scarf联合Akin截骨治疗中重度拇外翻畸形疗效分析

目的探讨Scarf联合Akin截骨治疗中重度拇外翻畸形临床疗效及手术指证。方法 68例108足中重度拇外翻畸形行Scarf截骨＋Akin截骨治疗,术后采用AOFAS评分联合X线片观察疗效及影像学改变。结果 68例获随访6~12个月;手术切口均一期愈合,截骨处愈合时间12周,无延迟愈合或不愈合,术后无并发症发生,治疗优良率96%;术后拇外翻角度、第1、2跖骨间角及胫侧籽骨位置（（5.70±1.25）°、（6.20±0.92）°、（2.48±0.51）级）均较术前（（40.20±5.43）°、（18.00±2.00）°、（4.98±0.65）级）明显下降（P〈0.05）,AOFAS评分（（88.30±7.06）分）较术前（（50.80±6.09）分）明显升高（P〈0.05）。结论 Scarf＋Akin截骨手术可技术互补,治疗中重度拇外翻畸形效果良好。

Scarf combined Akin osteotomies for moderate and severe hallux valgus

Objective To study the clinical efficacy and indications of Scarf combined with Akin osteotomies for moderate and severe hallux valgus.Methods Sixty-eight patients（108feet）received Scarf combined with Akin osteotomies,and were observed the imaging changes and therapeutic effect by AOFAS and X-ray examination.Results All patients were followed up for 6to 12 months.All operative incision healed primarily.The average healing time was 10 weeks at osteotomy part,with no delayed union or nonunion.No posterative complications occurred.The excellence rate was96%.The hallux vaigus angle,the 1-2intermetatarsal angle and tibial sesamoid position were lower after operation（（5.70±1.25）°,（6.20±0.92）°,（2.48±0.51））than those before operation（（40.20±5.43）°,（18.00±2.00）°,（4.98±0.65））.AOFAS was 88.30±7.06 after operation,higher than that before operation（50.80±6.09）（P〈0.05）.Conclusion Scarf surgery can complement Akin surgery,and the combination of them can achieve a good therapeutic effect for hallux valgus.