CAJ | 학술논문

目的：总结拇外翻矫形术后骨不连出现的原因及治疗策略。方法6例拇外翻矫形术后骨不连的患者,其中1例是第一跖骨远端截骨术后骨不连,5例是第一跖骨干及基底截骨术后骨不连。6例均行翻修术(清创+植骨内固定术)。结果术后切口均一期愈合,患者均获随访,随访时间12~18个月,平均随访15个月,末次随访时, X线检查见截骨端均完全愈合,无畸形及异常活动。结论拇外翻矫形术后引起骨不连的主要原因是局部骨质量差,如骨质疏松；感染导致内固定失效；术中软组织剥离范围大,影响供应跖骨的血运等。治疗策略主要取决于第一跖骨现有短缩程度及合并的软组织病变。
목적：총결무외번교형술후골불련출현적원인급치료책략。방법6례무외번교형술후골불련적환자,기중1례시제일척골원단절골술후골불련,5례시제일척골간급기저절골술후골불련。6례균행번수술(청창+식골내고정술)。결과술후절구균일기유합,환자균획수방,수방시간12~18개월,평균수방15개월,말차수방시, X선검사견절골단균완전유합,무기형급이상활동。결론무외번교형술후인기골불련적주요원인시국부골질량차,여골질소송；감염도치내고정실효；술중연조직박리범위대,영향공응척골적혈운등。치료책략주요취결우제일척골현유단축정도급합병적연조직병변。
ObjectiveTo summarize causes and treatment measures for postoperative nonunion after hallux valgus orthopedics.MethodsThere were 6 patients with postoperative nonunion after hallux valgus orthopedics, 1 case among them had postoperative nonunion after first metatarsal distal osteotomy, and the other 5 cases had postoperative nonunion after first metatarsal backbone and base osteotomy. All the 6 cases received revision surgery (debridement + bone grafting internal fixation).ResultsAfter surgery, all wound had first stage healing. Follow-up for the patients lasted for 12~18 months, with the average time as 15 months. X-ray examination in the last follow-up showed complete heal in osteotomy end, without malformation or abnormal movement.ConclusionMain cause of postoperative nonunion after hallux valgus orthopedics is poor local bone quality, such as osteoporosis, in fection-induced failed internal fixation, and wide range of soft tissue dissection in surgery, which will influence blood flow for supplying metatarsal bones. Treatment measures are mainly based on first metatarsal shortening degree and complicated lesion in soft tissue.