联合截骨术治疗单纯软组织手术后[足母]外翻畸形复发

Combined osteotomy in the treatment of recurrent hallux valgus deformity after simple soft tissue surgery

目的探讨Scarf联合Akin截骨术治疗单纯软组织手术后[足母]外翻畸形复发的疗效。方法采用Scarf联合Akin截骨术治疗18例单纯软组织手术后[足母]外翻畸形复发患者。记录术后并发症发生情况及AOFAS前足评分,测量[足母]外翻角(HVA)和第1-2跖间角(IMA)。结果患者均获得随访,时间12~24个月。切口均一期愈合。术后无骨不连、跖骨头坏死、畸形再复发和内翻等并发症发生。1足因螺钉摩擦刺激皮肤出现疼痛,1年后取出内固定后疼痛消失;2足出现轻度僵硬,予以加强趾关节功能锻炼后好转。末次随访时,HVA、第1-2IMA、AOFAS前足评分均较术前改善(P<0.05)。结论采用Scarf联合Akin截骨术治疗单纯软组织手术后[足母]外翻畸形复发可以有效矫正畸形,效果良好。

Objective To investigate the clinical efficacy of Scarf combined with Akin osteotomy in the treatment of recurrent hallux valgus deformity after simple soft tissue surgery.Methods The 18 patients who suffered from recurrent hallux valgus deformities after simple soft tissue surgeries were treated with Scarf combined with Akin osteotomy.The hallux valgus angle(HVA)and the first and second intermetatarsal angles(IMA)were detected.The postoperative complicaitons and AOFAS forefoot score were recorded.Results All 18 patients were followed up for 12~24 months.All incisions healed in one-stage.There were no complications such as nonunion,necrosis of metatarsal head,recurrence of deformity and hallux varus.Complications:1 foot had pain caused by screw friction,and the pain disappeared after removal of internal fixation at 1 year later;mild hallux toe stiffness occurred in 2 feet,which were improved after strengthening the functional exercise of hallux toe joint.At the last follow-up,HVA,the 1st,2nd IMA and AOFAS forefoot score were significantly improved,compared with those before operation(P<0.05).Conclusions Scarf combined with Akin osteomy can effectively correct recurrent hallux valgus deformity after simple soft tissue surgery,with good clinical effect.