游离第二足趾或关节移植术后供足X线改变

Influences on the donor foot x-ray in free toe and joint transfers

游离第２足趾或关节移植术是最主要的拇、手指再造方法之一。但至今尚未见有关供足Ｘ线方面研究的报告。笔者采用双足标准正位及负重侧位Ｘ线摄片,对２７例术后病人平均随访５．６６年。按手术截趾平面及随访时间不同行自身对照分层分析。结果：（１）第１跖骨和其近节趾骨长轴夹角比非手术侧平均增大３．7５°，原有用外翻畸形的病人，术后供足畸形加重;（２）跖骨截骨组的远期随访病人供足外侧纵弓平均增大３°;（３）术后供足１～３趾间距平均比非手术侧小９．1３ｍｍｉ（４）术后供足最大宽度变小：（５）跖骨截骨组４１．６７％的病人出现残留跖骨密度降低。本组只有少数病人稍感供足不适，但均不需治疗。

Free second toe and joint transfer is. one of the most important methods in thumb or fin- ger reconstruction. But so far. . report on the donor. foot X-ray changes. with both feet .under weight has. not been seen. We studied 27 cases. The average.. follow-up period was. 5. 66 years ( 3 month to 1 7 years) .. The result. were evaluated statistically by self-controlled and xectional xnalyxex according; to the plane of refection and follow-up time . The conclusion. were: .(1)The first metatnrsophalangeal angle averagoly increased 3. 75 degree , comparing with non-operative foot. The donor foot deformity would be more obvious in patients with hallux valnus after operation. (2)Lateral longitudi nal arch averngely in- creased 3 degree. in long term metatarsal resection cases. (3)The distance between big and third toe in the donor foot aversely shortened 9. 1 3 millimeters, (4 )The biggest width of the donor foot reduced after operation. (5 )In 41. 67 percent of patients. the density of survived metatarsal decreased.. slight trou- ble .existed in only a few patients in this group , and was notnoticed generally.