脚拇外翻微创矫形治疗新方法的疗效分析——附120例报告

ANALYSIS OF THE NEW SURGICAL TREATMENT FOR HALLUX VALGUS BY MICROHOLE ORTHOPEDIC OPERATION

[目的]探讨微孔矫形术治疗拇外翻畸形的手术治疗方法和临床疗效。[方法]本组120例176足拇外翻畸形采用微孔矫形术治疗,术前均摄片定位,测量拇外翻角度帮助确定截骨矫形多少,术后摄片。采用局部麻醉28例,局部神经阻滞麻醉98例,在拇趾近节内侧上开一3～5mm微孔,在微孔内手术,去除骨质增生,拇趾近节内侧斜行截骨。术中采用牵、接、按、摩、推、拿等中医手法,整复畸形,矫正拇趾脱位,复位一次完成。术中电视监视确定效果,30 min达到矫形的手术效果。[结果]本组随访6月～60个月,平均3年,参照温建民等拟定标准[5],优良率:优96.6%,良2.5%,差0.9%。[结论]微孔矫形术治疗拇外翻畸形是一种简便、安全、疗效显著的微创治疗方法。具有微创、恢复快、价廉、易掌握,有广泛的临床推广使用价值。

[Objective]To explore the clinical effect of the surgical treatment on hallus valgus with microhole orthopedic operation.[Methods] 120 patients （176 feet） with hallux valgus adopted the surgical treatment of microhole orthopedic operation.The osteotomy was designed by measuring preoperatiove radiographic hallux valgus angle.28 patients were placed under loco-regional anesthesia,98 under nerve block ,the surgical intervention stared with a 3-5-mm long medial skin incision that located at the proximal first phalange,the medial prominence was resected,oblique ostecotomy was completed througy interoperative reduction in the proximal first phalange in thirty minutes.[Results]All patients were followed up from 6 months to 60 months with an average of 3 years.According to WEN Jian-Min criteria,the rate of excellent and good was 99.1%,the rate of excellent outcomes was 96.6%,and good outcomes was 2.5%,fair outcomes was 0%,poor outcomes was 0.9% respectively.[Conclusion]The surgicla treatment of hallux valgus with microhole orthopedic operation is effective and safe, This method is Mini-trauma, less expensive. It can make a very soon rehabilitation and easy mastered, which have widely clinical value.