康复疗法在中西医结合治疗拇外翻术后的应用效果观察

目的观察中西医结合微创技术治疗拇外翻术后系统规范的康复治疗疗效。方法2006年7月—2008年9月本院采用中西医结合微创技术治疗拇外翻患者921例,术后进行了规范的康复治疗。其中77例144足获得完整随访1~3.5 a,平均2.3 a。观察手术前后拇外翻角(HAV角)、第1和第2跖骨间角(IM角)、拇趾-跖趾-趾间关节AOFAS评分、第1跖趾关节活动度、跖骨头下胼胝体(胼胝痛)等指标变化。结果本组患者术后关节功能优良率达98.6%。术后HAV角平均矫正21.03,°IM角平均矫正4.69°。术后第1跖趾关节活动度(跖屈+背伸)平均减小5.24°。术后AOFAS评分较术前提高31.52分。术前合并有跖骨头下疼痛93足,术后消失60足(64%),改善24足(26%),无改善、加重或新发6足(6%)。结论中西医结合微创技术治疗拇外翻术后进行系统规范的康复,可以有效防止跖趾关节粘连,恢复关节功能,减少转移性跖骨头下疼痛等手术并发症的发生,疗效肯定。

Application effect observation of rehabilitation therapy for Hallux Valgus after surgery with Chinese and western treatment

Objective It is to observe the curative effect of systemic and standard rehabilitation therapy for Hallux Valgus after surgery with Chinese and western microinjury treatment.Methods 921 cases of patients with Hallux Valgus were treated with surgery with Chinese and western microinjury treatment in our hospital from July in 2006 to November 2008,and were treated with standard rehabilitation therapy after the operation.77 cases including 144 feet were followed up for 1-3.5 a,and the average time was 2.3 a.The changes of indexes such as HAV coner,IM coner,AOFAS scores of thumb-metatarsus-joint,activity degree of first metatarsus joint,corpus callosum.Results The good rate of joint function after surgery in this group was 98.6%.The average correcting HAV corner was 21.03,and that of IM corner was 4.69 after operation.Activity degree of first metatarsus joint decreased 5.24 in average.AOFAS scores increased 31.52 scores after operation.There were 93 feet complicating with corpus callosum before surgery,in which there were 60 disappeared feet,24 improved feet,6 not improved,aggravated or new appeared feet.Conclusion Systemic and standard rehabilitation therapy for Hallux Valgus after surgery with Chinese and western microinjury treatment can effective prevent metatarsophalangeal joint adhesions,recovery joint function,decrease surgery complications such as transitivity pain of metatarsal bone head.Its curative effect is confirmed.