Endobutton悬吊钢板在拇外翻畸形中的新应用

背景:拇外翻是一种复杂的畸形,尚无治疗金标准,截骨治疗目前得到推崇,但并发症较多,能否进行不截骨矫正拇外翻是作者所在课题组进行的一项新尝试。目的:探讨Endobutton钢板悬吊固定治疗拇外翻畸形的效果。方法:2013年4月至2018年8月苏州大学附属常州肿瘤医院骨科采用Endobutton钢板悬吊固定治疗拇外翻26足,不截骨。所有患者对治疗方案均知情同意,且得到医院伦理委员会批准。术前、术后测量拇外翻角及第1,2跖骨间角,术后12个月评估美国足踝外科协会评分。结果与结论:①所有患者均获满意随访,随访周期8-38个月;②术后患者拇外翻角[(14.15±3.60)°vs.(28.95±4.12)°,P<0.01]及第1,2跖骨间角均显著小于术前[(7.88±0.90)°vs.(15.82±1.81)°,P<0.01]:③术后12个月患者美国足踝外科协会评分为(89.15±7.81)分,显著高于术前(62.08±7.10)分(P<0.01);④提示Endobutton钢板悬吊固定第1,2跖骨间是治疗拇外翻是一种可行的方案。

New application of Endobutton suspension plate in hallux valgus deformity

BACKGROUND:Hallux valgus is a complex deformity.There is no gold standard for the treatment of hallux valgus.Osteotomy is highly recommended at present,but there are many complications.Whether we can correct hallux valgus without osteotomy is a new attempt in our group.OBJECTIVE:To explore the efficacy of an Endobutton suspension plate treatment for hallux valgus deformity.METHODS:From April 2013 to August 2018 at Department of Orthopedics,Changzhou Tumor Hospital Affiliated to Soochow University,26 cases of hallux valgus were treated with En dobutto n suspensi on plate,without osteotomy.All patie nts signed the in formed consents and the study was approved by the hospital ethics committee.The hallux valgus angle and angle between metatarsal 1 and 2 were detected preoperatively and postoperatively.The American Orthopaedic Foot&Ankle Society score was detected at 12 months postoperatively.RESULTS AND CONCLUSION:(1)All patients were followed up from 8 to 38 months.(2)The hallux valgus angle(28.95±4.12)°and angle between metatarsal 1 and 2(15.82±1.81)°preoperatively were significantly decreased to(14.15±3.60)°and(7.88±0.90)°postoperatively(both P<0.01).(3)The American Orthopaedic Foot&Ankle Society score at 12 months after surgery(89.15±7.81)was significantly higher than that at baseline(62.08±7.10)(P<0.01).(4)In summary,Endobutton suspension fixation between metatarsal 1 and 2 for treating hallux valgus is a viable treatment option.