Chevron联合Akin术与Scarf联合Akin术矫正不同年龄拇外翻术后影像学参数的比较研究

A comparative study on imaging parameters of Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy for the correction of hallux valgus in patients at different ages

目的:比较分析Chevron联合Akin术与Scarf联合Akin术矫正不同年龄拇外翻患者的影像学参数。方法:随机选取在本院接受Chevron联合Akin术与Scarf联合Akin术治疗拇外翻的患者各40例,共80例,152只患足。接受上述术式治疗的患者按照年龄分为青年组和中老年组。采用专业X线测量软件测量术前和术后第2~3天每只患足的拇外翻角(hallux valgus angles,HVA)、第一跖骨远端关节面角(distal metatarsal articular angle,DMAA)和跖骨间角(intermetatarsal angles,IMA),研究两种术式对拇外翻角度的改善作用。结果:术后,青年组Chevron联合Akin术与Scarf联合Akin术对HVA和IMA均有明显的改善作用,与术前相比差异有统计学意义(P<0.001),并且两种术式的改善效果相似,差异无统计学意义(P>0.05)。但两种术式对青年患者DMAA的改善作用均不明显,与术前相比差异无统计学意义(P>0.05)。术后,中老年组Chevron联合Akin术与Scarf联合Akin术对HVA和IMA也均有明显的改善作用(P<0.001),两种术式的改善效果相似,差异无统计学意义(P>0.05)。此外,Chevron联合Akin术对中老年患者DMAA有明显的改善作用,与术前相比差异有统计学意义(P<0.001),但Scarf联合Akin术对中老年患者DMAA改善不明显,与术前相比差异无统计学意义(P>0.05)。结论:Chevron联合Akin术与Scarf联合Akin术均是临床治疗拇外翻应用广泛且有效的手术方法。Chevron联合Akin术能改善中老年患者DMAA,因此中老年拇外翻患者建议行Chevron联合Akin术。

Objective:To compare and analyze the imaging parameters of Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy for the correction of hallux valgus in patients at different ages.Methods:Eighty patients with hallux valgus(totally 152 feet of hallux valgus)who underwent Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy in our hospital were randomly selected.The patients were divided into the young and middle-aged groups.The hal‐lux valgus angles(HVA),distal metatarsal articular angle(DMAA),and intermetatarsal angles(IMA)were measured with pro‐fessional X-ray measurement software and then the effects of two osteotomy methods were evaluated.Results:After surgery,in the young group,Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy both significantly improved the HVA and IMA(P<0.001),and the improvement effects of the two osteotomy methods were similar(P>0.05).However,the effects of the two osteotomy methods on DMAA in the young patients were not significantly improved.After surgery,in the middle-aged group,Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy also significantly improved the HVA and IMA(P<0.001),and the improvement effects of the two groups were similar(P>0.05).In addition,Chevron combined with Akin osteotomy significantly improved DMAA in the middle-aged and elderly patients(P<0.001),but Scarf com‐bined with Akin osteotomy did not significantly improve DMAA in the middle-aged and elderly patients(P>0.05).Conclusion:Both Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy are effective and widely applied to the threatment of hallux valgus.Chevron combined with Akin osteotomy is able to improve DMAA in the middle-aged and elderly pa‐tients.Therefore,the middle-aged and elderly patients are much more suitable for the osteotomy of Chevron combined with Akin.