Photoshop软件在外翻术式选择及方案优化中的应用

Application of Photoshop in preoperative design and procedure selection of osteotomy for hallux valgus

背景:外翻矫形是临床最常见的足踝矫形手术,手术方法繁多而矫形效果差异较大,如何选择最佳术式以及术前模拟调整手术方案是目前研究的热点。目的:探讨采用Photoshop软件辅助外翻手术的术前设计,选择最佳术式及优化手术方案,探讨其临床应用价值。方法:2013年6月至2016年6月采用术前Photoshop软件辅助外翻手术的术前设计、方案选择,并行模拟截骨固定治疗外翻患者89例157足,男14例18足,女75例139足;年龄28~70岁,平均(56.3±10.8)岁。术前根据患者畸形情况制定手术方案,截骨部位、角度、截骨量均术前通过Photoshop软件测量确定,并通过软件行模拟截骨手术,从而优化手术方案。比较术前、术后及术后6个月随访时X线片的角度测量值,结合AOFAS评分观察疗效,并进行统计学分析。结果:实验组HVA、IMA、DMAA均矫形彻底,手术时间明显缩短,患者症状改善满意,术后并发症减少。结论:采用术前Photoshop软件辅助外翻手术的术式选择及优化手术方案,可明显减少术式选择及方案设计失误,从而提高手术效果,可广泛用于外翻手术治疗,复杂畸形及翻修患者更推荐使用。

Background： The osteotomy of the hallux valgus is the most common orthopedic operation in clinic. There are many methods of operation and great differences in clinical outcomes. How to choose an optimal procedure and preoperative osteotomy design have been becoming the hot spot of research. Objective： To investigate the role of Photoshop software in the selection of operation procedures and optimization of surgical design for the treatment of the hallux valgus. Methods：From June 2013 to June 2016, the Photoshop assisted osteotomy was performed in 89 patients（157 feet） with hallux valgus.There were 14 males（18 feet） and 75 females（139 feet） with an average age of（56.3±10.8） years old（range, 28-70 years old）. The operation plan was made on the basis of preoperative deformity. The site, angle and precise osteotomy were determined by Photoshop. Meanwhile, the osteotomy was simulated by Photoshop so as to adjust the operation plan. The X-ray angles were measured before operation, immediately after operation and at 6 months after operation. The curative effect was observed by AOFAS score and analyzed statistically. Results： The HVA, IMA and DMAA were adjusted thoroughly in all the patients. Shorter operative time, satisfactory improvement rate of symptoms and less postoperative complications were achieved in Photoshop assisted osteotomy. Conclusions： Photoshop software can assist to select appropriate procedure and optimize the operation plan for the hallux valgus, which can significantly reduce faults in the choice of procedures and surgical designs, thereby improving the clinical effect. It can be widely used in surgical treatment of the hallux valgus, especially for complicated deformities and revision.