拇外翻术后复发的危险因素分析和翻修手术治疗进展

Analysis of risk factors and progress on revision surgery for postoperative recurrence of hallux valgus

拇外翻复发是临床最常见且难以处理的拇外翻术后并发症之一。由于对拇外翻三维畸形与复发危险因素的认识不足,总体复发率居高不下,治疗方案的选择也仍有很大的争议。手术操作不当、重度畸形是已知的复发危险因素,而第1跖列不稳定、合并扁平足畸形等在拇外翻复发中的作用正受到国内外学者的更多关注。除第1跖趾关节融合术以外,改良Lapidus截骨、跖骨近端截骨等也被证明是疗效可靠的翻修术式。本文旨在总结拇外翻术后复发的相关危险因素,并针对复发后翻修手术的选择进行探讨,以期对拇外翻复发的预防与处理提供指导。

Recurrence of hallux valgus is one of the most common and difficult complications after surgery. Due to the lack of understanding of 3D deformity of hallux valgus and risk factors for recurrence,the overall recurrence rate is still high,and the choice of treatment is still controversial. Improper operation and severe deformity are known risk factors for recurrence,while the role of unstable of the first plantar train and combined flat foot deformity in the recurrence has been paid more attention by scholars at home and abroad. In addition to the first metatarsophalangeal fusion,modified Lapidus osteotomy and proximal metatarsal osteotomy have been proven to be reliable revision procedures. The purpose of this study is to summarize risk factors for recurrence of hallux valgus after surgery,and to explore the choice of revision surgery after recurrence,in order to provide guidance for prevention and management of recurrence of hallux valgus.