联合趾截骨手术在外翻矫形中的价值

The Evaluation of Akin Osteotomy to Treat Hallux Valgus

目的探讨趾截骨手术(Akin截骨术)在外翻畸形矫形中的价值。方法我院2010年5月至2011年4月联合使用Akin截骨术治疗外翻患者32例49足。在本组患者中,术前均拍摄患足负重正位X线片,测量外翻角、跖间角、远侧关节固定角,依据跖间角分别采用Chevron截骨术(Austin手术),跖楔关节融合手术(Lapidus手术)或第一跖骨基底斜楔形截骨(Juvara手术)。术后及随访测量外翻角、跖间角、远侧关节固定角改变。采用AOFAS评分对患足进行功能评价。结果所有患者平均随访12个月。外翻角由术前(39.7±7.5)°纠正为(16.1±7.6)°,P<0.05,平均纠正(25.9±9.5)°;跖间角由术前(15.4±3.9)°纠正为(7.6±2.5)°,P<0.05,平均纠正(7.1±3.0)°;远侧关节固定角由术前(6.3±2.7)°纠正为(-5.3±4.0)°,P<0.05,平均纠正(11.4±4.0)°;AOFAS得分由术前平均43.5分提高至85.6分,P<0.05。结论 Akin截骨术是外翻矫形程序中的一种辅助手术,可以改善疗效、降低复发率且操作简便、安全。

ObjectiveTo discuss the evaluation of Akin osteotomy to treat hallux valgus.MethodsA retrospective analysis was done for 49 feet of 32 patients with hallux valgus treated with Akin osteotomy in author′s department from May 2010 to April 2011.Weight-bearing anteroposterior X-ray were taken,and HVA,IMA,DASA were measured in all feet.Austin operation,Lapidus operation or Juvara operation were used according to IMA.The x-ray was taken to measure the change of HVA,IMA and DASA after operation and during the follow up.The function was valued by AOFAS scale.ResultsAll patients were followed up for 12 months.HVA changed from（39.7±7.5）° pre-operatively to（16.1±7.6）° at final follow-up（P〈0.05）.IMA changed from（15.4±3.9）° to（7.6±2.5）°,（P〈0.05）;DASA changed from（6.3±2.7）° to（-5.3±4.0）°,P〈0.05,mean（11.4±4.0）°;AOFAS scale increased from 43.5 pre-operatively to 85.6 at final follow-up,P〈0.05.ConclusionAkin osteotomy was an auxiliary operation to treat hallux valgus,which can improve the effect of the operation,decrease recurrence rate and be taken easily and safely.