CAJ | 학술논문

目的探讨第1跖骨近端新月形截骨联合远端软组织重建手术治疗重度(足母)外翻的方法.方法 2008年1月至2012年12月,采用第1跖骨近端新月形截骨联合远端软组织重建手术治疗重度(足母)外翻21例,男性1例1足,女性20例20足,年龄36～ 68岁,平均52岁.所有病例均获得随访,比较手术前、后X线上(足母)外翻角度的测量值,并结合美国足与踝关节协会(AOFAS)前足评分观察手术疗效.结果本组21例,术后随访时间为12～ 26个月,平均16个月,无截骨不愈合及延迟愈合现象.患者术前(足母)外翻角为42.3°±1.8°,第1、2跖骨间角21.9°±1.7°,第1跖骨远端关节面倾斜角14.9°±1.8 °;术后(足母)外翻角矫正至14.5°±1.8°,第1、2跖骨问角9.1°±1.8°,第1跖骨远端关节面倾斜角7.2 °±1.5 °.上述3个角度术前、后比较,差异有统计学意义(P＜0.05).AOFAS评分术前为44.0±1.8分,术后为83.9±2.2分.结论对第1、2跖骨间角增大的重度(足母)外翻患者,采用第1跖骨近端新月形截骨联合远端软组织重建手术,可获得良好的术后效果.
목적 탐토제1척골근단신월형절골연합원단연조직중건수술치료중도(족모)외번적방법.방법 2008년1월지2012년12월,채용제1척골근단신월형절골연합원단연조직중건수술치료중도(족모)외번21례,남성1례1족,녀성20례20족,년령36～ 68세,평균52세.소유병례균획득수방,비교수술전、후X선상(족모)외번각도적측량치,병결합미국족여과관절협회(AOFAS)전족평분관찰수술료효.결과 본조21례,술후수방시간위12～ 26개월,평균16개월,무절골불유합급연지유합현상.환자술전(족모)외번각위42.3°±1.8°,제1、2척골간각21.9°±1.7°,제1척골원단관절면경사각14.9°±1.8 °;술후(족모)외번각교정지14.5°±1.8°,제1、2척골문각9.1°±1.8°,제1척골원단관절면경사각7.2 °±1.5 °.상술3개각도술전、후비교,차이유통계학의의(P＜0.05).AOFAS평분술전위44.0±1.8분,술후위83.9±2.2분.결론 대제1、2척골간각증대적중도(족모)외번환자,채용제1척골근단신월형절골연합원단연조직중건수술,가획득량호적술후효과.
Objective To explore the method of the treatment for hallux valgus with the proximal crescentic osteotomy of the first metatarsal bone,combining with distal lateral soft tissue release.Methods From January 2008 to December 2012,21 eases 21 hallux valgus feet were treated by operative procedure,included 1 male (1 foot) and 20 females(20 feet),with the mean age of 52 years (range,36-68 years).Among all patients were followed up for 12 to 26 months,with the mean 16 months.The preoperative,postoperative and final follow-up X-ray films of all patients were collected.The hallux valgus angle,intermetatarsal angle and distal metatarsal articular angle were measured and analyzed.The surgical outcome was evaluated combined with the AOFAS score.Results The average hallux valgus angle decreased from 42.3° ± 1.8° preoperatively to 14.5° ± 1.8° postoperatively,the average intermetatarsal angle did from 21.9°±1.7° to 9.1° ± 1.8°,and the average distal metatarsal articular angle did from 14.9° ± 1.8° to 7.2°± 1.5°,respectively.There were significant differences between the preoperative and postoperativeroentgenographic index.AOFAS score was improved from 44.0 ± 1.8 preoperatively to 83.9 ± 2.2 at thefinal follow-up.Conclusions The proximal crescentic osteotomy of the first metatarsal bone combineddistal soft tissue reconstruction obtained satisfactory results in severe hallux valgus patients with bigintermetatarsal angle.