Chevron截骨术治疗足拇外翻的疗效观察

目的探讨应用第一跖骨远端Chevron截骨术治疗轻度拇外翻的临床疗效。方法对13例22足轻度拇外翻患者采用第一跖骨远端Chevron截骨术进行治疗。患足术前术后摄负重正侧位X线片,进行AOFAS评分以评价功能和疼痛情况,并对结果进行统计学分析。结果所有患者均获得随访(平均11个月)。所有患者截骨端均达骨性愈合,平均临床愈合时间为6周。未出现血管、神经损伤或感染等并发症,至末次随访未出现一例内固定松动、断裂,拇外翻复发或第一跖骨头缺血坏死、转移性跖骨痛等并发症。术前HVA平均25.2°,术后为5.6°;术前IMA平均11.4°,术后为6.3°;术前AOFAS评分为52.4分,术后至末次随访时为87.5分。各项指标术前术后对比差异均有统计学意义(P<0.01)。结论第一跖骨远端Chevron截骨术治疗轻度拇外翻,近期疗效满意。

Preliminary reports of Chevron osteotomy for correction of hallux valgus

Objective To study the clinical results of distal Chevron osteotomy for correction of mild hallux valgus.Methods 13 patients(22 feet) were treated by distal Chevron osteotomy for correction of mild hallux valgus.The hallux valgus angle(HVA) and intermetatarsal angle(IMA),and AOFAS score were measured preoperatively,and followup postoperatively and complications were evaluated.The results were analyzed by SPSS software.Results All patients were followed up average eleven months.All got bony heal at 6 week on average.No patient had got complications include damage of vessel or nerve,infection,movement or broken of fixation,recurrence of hallux valgus,avascular necrosis of the first metatarsal head or transfer metatarsalgia.The HVA was 25.2 degree preoperation and 5.6 degree postoperation.The IMA changed from 11.4 degree to 6.3 degree pre-and postoperation.The AOFAS scores yet changed form 52.4 to 87.5 at the last followup.There was significant difference before and after operation in all targets(P<0.01).Conclusion The distal Chevron osteotomy of the first metatarsal is an effective method and it deserved to indicated for mild hallux valgus.