经皮Chevron截骨术治疗轻中度足拇外翻畸形

Percutaneous Chevron osteotomy in treating mild to moderate hallux valgus deformity

目的评估经皮Chevron截骨术治疗轻中度足拇外翻畸形的疗效。方法2010年6月至2012年5月，采用经皮Chevron截骨术治疗24位（26例）轻中度足拇外翻患者。所有患者均为女性，平均年龄48岁，其中右足14例，左足12例。术前和末次随访时测量足拇外翻角、跖骨间角，并进行美国足踝骨科学会（AOFAS）前足评分。术前足拇外翻角20°～40°，跖骨间角小于20°，跖骨远端关节角小于10°。结果术后平均随访26．3个月，足拇外翻角由术前平均31．68°纠正至术后平均14．39°，跖骨间角由术前平均13．77°纠正至术后平均7．98°，AOFAS前足评分由术前平均59．26分改善至术后平均88．35分。术后4例出现内侧关节囊折叠缝合引起的刺激症状，4例出现螺钉尾端刺激症状，但无伤口感染、关节僵硬及跖骨头坏死等并发症发生。结论经皮Chevron截骨术中期随访结果较好，可有效治疗轻中度足拇外翻畸形。

Objective To evaluate the results of percutaneous Chevron osteotomy for mild to moderate hallux valgus. Methods From June 2010 to May 2012, 24 patients （26 feet） with hallux valgus were treated with percutaneous Chevron osteotomy. All of them were females with the mean age of 48 years. There were 14 right feet and 12 left feet. Preoperatively, the hallux valgus angle （HVA） ranged from 20° to 40°, the inter-metatarsal angle （IMA） was less than 20°, and the distal metatarsal articular angle （DMAA） was less than 10~. Results At final follow up （mean, 26. 3 months） postoperatively, the mean HVA reduced from 31.68° to 14. 39°, the mean IMA reduced from 13.77°to 7.98°, and the mean American Orthopedic Foot and Ankle Society （AOFAS） score improved from 59.26 to 88.35. There were 4 cases of medial plication stitch impingement and 4 cases of screw impingement, but no other complications such as wound infection, joint stiffness, and avascular necrosis of metatarsal head occurred. Conclusion The mid-term result is encouraging, and indicating this method is effective in treatment of mild to moderate hallux valgus.