Scarf截骨治疗中重度外翻的短期疗效分析

Short term effect of Scarf osteotomy on moderate to severe hallux valgus

背景:外翻是最常见的前足畸形,越来越受到矫形外科医生的重视,其治疗方式多种多样,如何选择适合的手术方式是治疗成功的关键。目的:探讨Scarf截骨术治疗外翻的疗效。方法:2010年7月至2012年6月,我院采用Scarf截骨术治疗中重度外翻患者47例(61足),男5例(7足),女42例(54足);年龄20～78岁,平均52.2岁。比较手术前后外翻角及第1、2跖骨间角纠正程度。采用AOFAS评分评估患者临床症状改善情况。结果:所有患者均获得随访,随访时间4～8个月,平均6个月。外翻角由术前42.6°减小至12.9°,平均减小29.7°。第1、2跖骨间角由术前18.4°减小至8.9°,平均减小9.5°。AOFAS评分由术前49.9分增加至术后86.2分,平均增加26.5分。并发症发生率10%。结论:Scarf截骨术治疗中重度外翻可以获得较好的短期临床结果,但需严格掌握手术适应证。

Background： Hallux valgus is the most common deformity in forefoot. There are many treatments for it. Therefore, it is very important to choose an appropriate surgical therapy for each patient. Objective： The purpose of the study is to explore the efficacy of Scarf osteotomy for the treatment of hallux valgus Methods： From July 2010 to June 2012, 47 patients with 61 feet underwent Scarf osteotomy for the treatment of moderate to severe hallux valgus. There were 5 males （7 feet） and 42 females （54 feet） with an average age of 52.2 years （range, 20-78 years）. The hallux valgus angle （HVA） and intermetatarsal angle （IMA） were compared before and after surgery. Clinical outcomes were assess by American Orthopedic Foot and Ankle Society （AOFAS） scoring. Results： The mean duration of follow-up was 6 months in all the patients （range, 4-8 months）. HVA was decreased by 29.7° （from 42.6° preoperative to 12.9°postoperative）. IMA was decreased by 9.5°（from 18.4° preoperative to 8.9° postopera- tive）. AOFAS score was increase by 26.5 points （49.6 points preoperative to 86.2 points）. The incidence of complications was 10%. Conclusions： Satisfied short-term clinical outcomes can be achieved by Scarf osteotomy for moderate or severe hallux valgus. However, indications should be mastered before treatment.