三截骨术在重度拇外翻治疗中的临床研究

Clinical study on three osteotomy in the treatment of severe hallux valgus

目的探讨三截骨术治疗重度拇外翻的临床应用价值。方法回顾分析25例（35足）重度拇外翻患者的手术治疗效果及术后并发症发生情况，比较分析手术前后AOFAS评分、HVA及IMA。结果参照AOFAS足拇外翻疗效评定标准，35足愈后的优良率为94．3％；术后AOFAS评分（88．7±5．2）分，比术前（41．7±8．4）分显著增高（t=3．47，P〈0．05）；而术后HVA值[（10．2±2．1）°]及IMA值[（7．4±1．3）°]比术前HVA值[（55．7±14．2）°]及IMA值[（22．7±4．8）°]显著降低（t=4．31、3．38，均P〈0．05）。35足中，术后前足内侧有麻木者8足，跖趾关节活动轻度受限者3足，余均未发生严重并发症。结论三截骨术治疗重度拇外翻疗效确切，并发症少，值得在临床推广应用。

Objective To explore the application value of three osteotomy in the treatment of severe hallux valgus. Methods 25 patiens with severe hallux valgus who were treated were selected. The results of surgical treatment and postoperative complications were retrospectively analyzed, and preoperative and postoperative AOFAS score, HVA and IMA were comparatively analyzed. Results AOFAS hallux valgus feet with reference to evaluation standard,35 foot excellent prognosis was 94.3%. Postoperative AOFAS score（ 88.7 ± 5.2 ） compared to the preoperative （41.7 ± 8.4 ） was significantly higher（P 〈 0.05 ） ,while the postoperative HVA values（ 10.2 ± 2.1 ） ° and IMA value （ 7.4 ± 1.3 ） ° compared to preoperative （ 55.7 ± 14.2） ° and IMA values （ 22.7 ± 4.8 ） ° were significantly lower （ P 〈 0.05 ）. 35 feet, the inside of the front foot ＇after the numbness in 8 feet, metatarsophalangeal joints slightly limited by 3 feet,while the remainder were serious complication. Conclusion Three osteotomy for severe hallux valgns had acute efficaey and fewer complications, which is worth clinical application.