足横弓重建法治疗外翻

目的 :介绍一种伴有足横弓塌陷的严重外翻的手术方法。方法 :12例伴有足横弓塌陷的严重的外翻足首先经X线、CT检测其三维畸形程度 ,而后手术中采用第一跖骨基底截骨 ,远端外推、下压、外旋以纠正第一跖骨的三维畸形 ,恢复足横弓正常形态 ,矫形位置以克氏针固定 :对外翻角 (HVA)的纠正采用常规第一跖趾关节软组织手术。结果 :术后 3～ 12月随访 ,优 6例、良 4例、中 2例 ,优良率 83 % ,其中 ,前足底中部痛性胼胝均有明显减轻。结论 :足横弓重建手术是严重外翻较好的选择术式。

Treatment of Hallux Valgus with Reconstruction of the Transverse Arch of the Foot

Objective:To introduce a new surgical procedure for the severe hallux valgus with prolapsed transverse arch of the foot.Methods:Twelve hallux valgus feet with prolapsed transverse arch were evaluated with X ray and CT scanning to measure their 3 Dimentional deformity before operation.In the operation,routine distal soft tissue operation was performed to correct the hallux valgus angle(HVA),in order to correct the 3 dimentional deformity of the first metatarsal,basal osteotomy of it was made,distal segment was replaced with lateral pushed down ward pressed and supine rotated.Then,the corrected position of the first metatarsal was fixed with kirschner wire.Results:In the follow up 3 12 months after operation,excellent outcome was gotten in 6 cases,good in 4 cases and fair in 2 cases.And painful metatarsal callus released in all cases.Conclusion:Procedure of reconstruction of the transverse arch of the foot was a valuable alternative treatment for severe hallux valgus.