Scarf联合Akin手术治疗中重度拇外翻的疗效

Observation of the effects of Scarf combined with Akin osteotomy on moderate and severe hallux valgus

目的研究探讨Scarf联合Akin截骨术治疗中重度拇外翻的疗效并讨论出现的并发症。方法选取2015年6月至2016年5月治疗的中重度拇外翻患者53例(60足),采用Scarf联合Akin截骨术治疗,术前HVA为(37.2±7.5)°;IMA为(16.9±2.7)°;DMAA为(13.5±3.8)°,术前AOFAS评分为(67.1±2.9)分。结果 53例患者(60足)术后随访36个月。1例(1足)出现转移性跖痛;1例(1足)患者出现深部感染;1例(1足)复发。术后HVA为(12.9±1.4)°,IMA为(9.5±1.3)°,DMAA为(10.5±2.5)°,AOFAS评分为(95.3±7.3)分,与术前相比均有改善(P <0.01)。结论 Scarf联合Akin截骨可以有效纠正畸形,改善前足功能,是治疗拇外翻的有效方法,但是要避免并发症的出现。

Objective To investigate the effects of Scarf combined with Akin osteotomy on hallux valgus.Methods 53 patients(60 feet)of hallux valgus who were operated from June 2015 to May 2016 with Scarf osteotomy combined with Akin osteotomy.The preoperative HVA was(37.2±7.5)°and(16.9±2.7)°;DMAA is(13.5±3.5)°.The preoperative AOFAS score was(67.1±2.9)points.Results 53 patients(60 feet)were followed up for 36 months after operation.None of them developed bone nonunion.There is one patient(1 foot)with metatarsalgia,one patient(1 foot)with deep infection,one patient(1 foot)with necrosis of head of first metatarsus.Postoperative parameters were:HVA(12.9±1.4)°,IMA(9.5±1.3)°,DMAA(10.5±2.5)°,and AOFAS score(95.3±7.3)points.There parameters were all improved compared with those before operation(P<0.01).Conclusion Scarf osteotomy combined with Akin osteotomy can correct deformity and improve symptoms.Therefore,it is an effective method for the treatment of hallux valgus.