CAJ | 학술논문

目的探讨改良Ludloff截骨术治疗的重度拇外翻的中期治疗效果.方法 2006年3月至2008年3月应用改良Ludloff截骨结合远端软组织手术治疗重度拇外翻患者25例(30足),其中4足加行Reverdin手术,3足加行Akin手术.患者均行患足负重位X线片并测量拇外翻角,随访24～35个月,平均28.3个月,按美国骨科足踝外科协会Maryland评分标准对疗效进行评定.结果 25例患者全部得到随访,术后无不愈合及畸形愈合,1例老年患者延迟愈合,伤口无感染.Maryland拇趾评分标准:优(90～100分)19足(63.3%),良(80～89分)8足(26.7%),可(70～79分)3足(10.0%),优良率90.0%.与治疗前相比,差异有统计学意义(P＜0.05).结论改良Ludloff截骨术具有愈合快、跖骨短缩少、纠正畸形能力强的优点,可以明显减轻前足的疼痛,恢复足部的功能,是治疗合并第1跖骨内翻特别是重度拇外翻的较理想术式.
목적 탐토개량Ludloff절골술치료적중도무외번적중기치료효과.방법 2006년3월지2008년3월응용개량Ludloff절골결합원단연조직수술치료중도무외번환자25례(30족),기중4족가행Reverdin수술,3족가행Akin수술.환자균행환족부중위X선편병측량무외번각,수방24～35개월,평균28.3개월,안미국골과족과외과협회Maryland평분표준대료효진행평정.결과 25례환자전부득도수방,술후무불유합급기형유합,1례노년환자연지유합,상구무감염.Maryland무지평분표준:우(90～100분)19족(63.3%),량(80～89분)8족(26.7%),가(70～79분)3족(10.0%),우량솔90.0%.여치료전상비,차이유통계학의의(P＜0.05).결론 개량Ludloff절골술구유유합쾌、척골단축소、규정기형능력강적우점,가이명현감경전족적동통,회복족부적공능,시치료합병제1척골내번특별시중도무외번적교이상술식.
Objective To explore the midterm effect of modified Ludloff osteotomy for the treatment of severe hallux valgus deformity associated with metatarsus primus varus. Methods Totally 25 patients(30 feet) with severe hallux valgus deformity were treated by modified Ludloff osteotomy and distal soft tissue procedure from March 2006 to 2008 March. Four feet were treated furtherly with reverdin osteotomy. Three feet were treated furtherly with Akin osteotomy. All the patients underwent weight bearing radiograph examination. The follow-ups ranged from 24 to 35 months ( average 28.3 months). The effect was evaluated by Maryland clinical rating systems of AOFAS.Results All the patients underwent the follow-up. There was no bone nonunion, malunion and wound infection,but one old patient had delayed union. According to Maryland clinical rating systems of AOFAS, 19 feet(63.3%)were excellent ( 90 to 100 scores), 8 feet ( 26.7 % ) were good ( 80 to 89 scores), 3 feet ( 10. 0% ) were middle (70 to 79 scores). Conclusions Modified Ludloff osteotomy has the advantage of rapid healing, less shortened metatarsal and ability to correct deformity, which can relieve the pain and recover the function of forfoot. It is a perfect procedure for severe hallux valgus deformity patients whose intermetatarsal angle is over 16°.