手术治疗外翻合并跖骨痛的短期临床疗效

Short-term clinical effects of surgical treatment on hallux valgus associated with metatarsalgia

目的分析手术治疗外翻合并跖痛的短期临床效果,探索手术疗效好、并发症少的治疗方式,为今后临床治疗选择提供依据。方法选取21例外翻合并跖骨痛的患者作为研究对象,采用单纯外翻矫正手术,不同时进行外侧跖骨短缩手术治疗外翻合并跖骨痛。通过对术前及术后的AOFAS评分,VAS视觉模拟评分,以及负重正位X线测量指标的对比来比较手术效果。结果所随访的19例中,术后跖骨痛的治愈率为78.6%,疼痛改善率为92.8%。术后6个月趾AOFAS评分,外侧足趾AOFAS评分和VAS视觉模拟评分较术前明显改善,且差异具有统计学意义(P<0.001);外翻角和第1、2跖骨间夹角与手术前相比明显减小,差异均有统计学意义(P<0.001)。结论 外翻合并跖痛症患者采用单纯外翻矫正手术进行治疗时可获得较好的临床疗效,外翻畸形得到显著纠正,同时跖骨痛的症状也可以得到明显缓解,大部分足底胼胝显著减轻或消失。

Objective To analyze the short-term clinical effect and appropriate method of surgical treatment for hallux valgus associated with metatarsalgia in order to provide the evidence for the future treatment options. MethodThe 21 patients with hallux valgus and metatarsalgia were enrolled. They were treated by the simple correction of hallux valgus without shortening the lateral metatarsals. The clinical results were analyzed by comparing the AOFAS scores, VAS scores, and weight-bearing X-ray parameters pre- and post-operation. Result Of the 19 patients followed up, the healing rate of metatarsalgia was 78.6%, while the improvement rate of pain was 92.8%. Six months after the operation, the AOFAS and VAS scores were significantly improved（P〈0.001）, and the hallux valgus angle（HVA） and the 1-2 intermetatarsal angle（IMA） became significantly smaller（P〈0.001）. Conclusion The patients are successfully treated, with their hallux valgus greatly corrected, pain remarkably relieved, and most of plantar callosity obviously alleviated.