一种新的(足,母)外翻矫形术--第一跖骨斜行截骨术的疗效分析

目的探讨和总结第一跖骨斜行截骨术治疗外翻畸形的临床效果和优越性.方法对一组46例54足术前常规摄前足负重正位片测量外翻角(HVA)、跖间角(IMA)、近侧关节固角(PASA).全部病例均施第一跖骨斜行截骨术19例联合趾近节趾骨楔型截骨术,6例联合其他跖骨截骨矫正外翻畸形.结果随访6.2～44.0个月,平均19.6个月.所有外翻畸形足全部矫正,术后前足负重正位片测的HVA,IMA和PASA与术前相比有明显差异(P<0.01),优良率达94.4%.发生第一跖骨骨折1例.结论第一跖骨斜行截骨术对于矫正外翻畸形较之其他术式的适用范围更广,不仅可以单独使用,也可和其他术式联合使用,且操作简单,固定牢固,可行早期功能锻炼,并发症少.对重度畸形者更显其优越性.

Analysis of new orthopaedic procedure:Oblique osteotomy of the first metatarsal in treatment of hallux valgus deformity

Objective To investigate the effect and advantage of oblique os teotomy of the first metatarsal in treatment of hallux valgus deformity. Method The measurement of hallux valgus angle(HVA), intermetatarsal an gle(IMA), and proximal articular set angle(PASA) were obtained from preoperative standing forefoot AP radiographs. All patients were treated with oblique osteot omy of the first metatarsal, 19 feet of which combined with the great toe proxim al phalangeal osteotomy and 6 feet with other metatarsal osteotomy.Resul ts The range of follow-up were from 6.2 to 44.0 months (average 19.6 m on ths ). All hallux valgus deformity were corrected. There was a significant diffe rence between preoperative and postoperative measurements of forefoot standing A P radiographs in HVA, IMA and PASA (P<0.01). The fineness rate was u p to 94.4%. One foot complicated with fracture of the first metatarsal.C onclusions Oblique osteotomy of the first metatarsal for treatment of hallux valg us is wider than other procedures in range of indications, which can be combined with other procedures and performed simply. Its strong fixation allows an early functional recovery. Oblique osteotomy of the first metatarsal is an effective and reliable procedure to correct the hallux valgus deformity, especially for se rious hallux valglus, with a minimum of complications.