Chevron+Akin截骨结合外侧软组织松解术应用全螺纹加压螺钉治疗中重度[母]外翻

Application of full thread compression screw in Chevron and Akin osteotomy combined with lateral soft tissue lysis to treat moderate and severe hallux valgus

目的探讨Chevron+Akin截骨结合外侧软组织松解术应用全螺纹加压螺钉治疗中重度[母]外翻的手术方法和疗效。方法回顾性研究2015年6月-2019年6月采用Chevron+Akin截骨结合外侧软组织松解术应用全螺纹加压螺钉治疗的中重度[母]外翻患者16例(23足)病例资料,通过术前、术后随访及对影像学资料进行对比,采用美国足踝外科协会AO-FAS评分进行疗效评估。结果16例全部获随访,时间6~36个月,平均19.3个月。[母]外翻角(hallux valgus angle,HVA)由术前36.12°±4.36°降至术后9.99°±2.30°;第1、2跖骨间角(inter metatarsal angle,IMA)由术前14.27°±2.18°降至术后8.59°±1.56°;患者足部疼痛症状明显好转,术后[母]外翻外形得到改善。采用美国足与踝关节协会制定的AO-FAS足[母]趾-跖趾关节-趾间关节功能评分量表,由术前(50.00±3.93)分提高至术后(88.56±3.43)分(P<0.05)。结论Chevron+Akin截骨结合外侧软组织松解术应用全螺纹加压螺钉治疗中重度[母]外翻,患者足部外形及症状改善明显,疗效满意。

Objective To explore the surgical method and effect of Chevron osteotomy combined with lateral soft tissue release and Akin osteotomy combined with full thread compression screw fixation in the treatment of moderate to severe hallux valgus.Methods This study was a retrospective study.Sixteen patients(23 Foots)with moderate to severe hallux valgus treated with Chevron osteotomy combined with lateral soft tissue release and Akin osteotomy combined with full thread compression screw fixation were admitted to Siping Central Hospital from June 2015 to June 2019.Through the comparison of X-ray and external image results during the follow-up before and after the surgery and choosing the American Association of Foot and Ankle Surgery AO-FAS score for efficacy evaluation.Results All 16 cases were followed up for 6 to 36 months,with an average of 19.3 months.HVA decreased from preoperative 36.12°±4.36°to postoperative 9.99°±2.30°,and IMA decreased from preoperative 14.27°±2.18°to postoperative 8.59°±1.56°,indicating that the patient’s foot pain diminished significantly and the visional shape of hallux valgus was better modulated after surgery.Using the the AOFAS metatarsophalangeal-interphalangeal scoring scale developed by the American Foot and Ankle Association,the score increased from(50.00±3.93)points before surgery to(88.56±3.43)points after surgery(P<0.05).Conclusion The conditions of foot visional shape and pain are significantly improved for patients with moderate to severe hallux valgus treated with Chevron osteotomy combined with lateral soft tissue release and Akin osteotomy combined with full thread compression screw fixation and the overall effect is satisfactory.