截骨内固定术结合拇收肌切断术治疗拇外翻的临床探讨

Treatment of hallux valgus by osteotomy and internal fixation combined with adductor pollicis amputation

目的通过观察、分析及对比随访5年的60例拇外翻患者临床表现、术前及术后患足X片,以期找到一种有效的治疗方法。方法对重度拇趾外翻患者,根据其年龄、全身情况、临床表现及术前患足负重位正斜位X片检查结果,行相应的截骨术、内固定术,并结合拇收肌切断术进行治疗。结果本组术后3、6个月及术后1、3、5年复查,患足正斜位X片显示拇外翻角得到有效纠正,拇外翻角均控制在20°以内。随访5年仅2例发现拇外翻角纠正丢失,其余病例纠正的拇外翻角均无明显丢失,未见骨折畸形愈合或不愈合。结论截骨内固定术结合拇收肌切断术是治疗重度拇外翻行之有效的方法。

Objective To find an effective method for the treatment of hallux valgus through the observation, analysis, and comparison of the clinical manifestations and preoperative and postoperative X ray files during the five-year follow-up in 60 cases of hallux valgus. Methods The patients with severe hallux valgus received osteotomy and internal fixation combined with adductor pollicis amputation according to their age, general conditions, clinical manifestations, and the preoperative examination results of the affected ioot weight loading and oblique position X ray films. Results In the reexamination 3 and 6 months and 1 year, 3 and 5 years after the operation,the oblique position X ray film of the affected foot showed that the hallux valgus was effectively corrected, and the valgus angle was controlled within 20°. During the five-year follow-up,only two cases had the correction loss of hallux valgus angle. Other cases had no obvious correction loss, fracture malunion or disunion. Conclusion 0steotomy and internal fixation combined with adductor pollicis amputation is an effective method for the treatment of severe hallux valgus.