改良型Mc Bride矫形手术治疗足拇外翻的效果

目的探讨改良型Mc Bride手术治疗足拇外翻的效果。方法 2012年4月-2013年4月,我科采用改良型Mc Bride手术治疗中重度拇外翻病人25例42足。观察手术效果,比较手术前后拇外翻角（HVA）、第一二跖骨间角（IMA）及足踝AOFAS评分的变化。结果术后全部病人均获6-18个月随访。截止最后一次随访,42足中37足基本无疼痛,5足偶有疼痛,VAS评分均在0-3分之间。外翻畸形全部得到矫正,无复发。术后1d、术后6月病人HVA和IMA均较术前明显减小（t=3.34-3.76,P〈0.05）,术后6月与术后1d比较差异无显著性（P〉0.05）。术后6月病人AOFAS评分与术前比较差异有显著性（t=5.74,P〈0.05）。结论改良型Mc Bride手术能够确切地纠正足拇外翻畸形,有效缓解足拇外翻及继发拇囊炎而导致的疼痛。

EFFICACY OF MODIFIED MC BRIDE ORTHOMORPHIA FOR HALLUX VALGUS

Objective To assess the efficacy of modified Mc Bride surgery for hallux valgus（HV）. Methods From April 2012 to April 2013,42 cases of moderate to severe HV in 25 patients were treated by modified Mc Bride procedure in our department.The surgical results were observed,and the changes of hallux valgus angle（HVA）and inter-metatarsal angle（IMA）before and after surgery,and American Orthopaedic Foot and Ankle Society（AOFAS）score were compared. Results All the patients were followed for six to 18 months after surgery.To the end of the last follow-up,37 of the 42 feet were pain free,five with occasional pain,the VAS score being 0-3.All valgus deformity was corrected with no recurrence.The HVA and IMA,one day and six months postoperatively,were obviously reduce as compared with before surgery（t=3.34-3.76,P〈0.05）,but the difference of HVA and IMA between one day and six months after surgery was not significant（P〉0.05）.The difference of AOFAS between before and after operation was significant（t=5.74,P〈0.05）. Conclusion Modified Mc Bride procedure can definitely correct foot hallux valgus deformity and effectively relieve the pain due to the disease.