Keller手术治疗外翻疗效分析

目的 观察Keller手术治疗(足母)外翻疗效。方法 对我院1978年1月-1995年12月间因(足母)外翻住院并行了Keller矫形术的病人进行随访,共随访到70例(118足)有效病人。术后时间为5～24年,平均9年,对(足母)趾及前足部症状改善,畸形矫正程度,足趾功能及术后各种并发症进行统计和分析,同时通过负重足印观察比较Keller矫形术对前足负重点的影响。结果Keller手术后病人(足母)趾及前足症状改善,(足母)外翻及叠趾畸形、矫正满意者98足,手术优良率为83％。并发症主要为(足母)趾麻木,(足母)外翻复发或未矫正,(足母)内翻,(足母)抓地力量弱,第二趾屈曲挛缩等,部分病人需要再次手术。结论 Keller手术通过(足母)跖近节趾骨截骨及(足母)跖趾关节成形,以达到(足母)外翻矫正的目的。对年龄较大、(足母)外翻严重,或同时合并(足母)跖趾关节骨关节炎的患者是一个较好的治疗方法。近节趾骨截骨是手术成功的关键。

Analysis of the effect of Keller's operation on hallux valgus

Objective To observe clinical effect of Keller's operation on hallux valgun Methods From 1978 to 1995,70 cases(118 feet) of hallux valgus were followed up with an average of 9 years after Keller's operation. The symptoms improvement in the big toe and the forefoot,the deformity correction,the function of toes and the various complication after operation were analyzed. At the same time, the change of weight-bearing point via the foot print after operation were analyzed. Results 98 feet got satisfied results after the Keller' s operation from the symptoms improvement and the correction of the hallux valgus and over-lapped toes. According to standard of Wenjianmin, the efficacious rate of operation was 83%. The complications were the numbness, valgus recurrence, hallux varus, flexion weakness of big toe, the flexion contracture of the second toe. Conclusion The Keller's operation can reach the goal of the complete correction of the first phalanx-mete-tarsal joint through the osteotomy of the first proximal phalanx. The Keller's operation is a good choice for those patients with old age,severe hallax valgus and combined osteoarthritis. The osteotomy of the first phalanx is key for successful operation.