改良小针刀松解踇收肌联合正骨复位治疗轻中度踇外翻临床观察

Modified Small Needle Knife Releasing Adductor Hallucis Muscle and Bone Setting Reduction in the Treatment of Mild to Moderate Hallux Valgus

目的对照研究改良小针刀松解踇收肌联合中医正骨复位治疗轻中度踇外翻的临床效果。方法选取于赣州市立医院骨科就诊的轻中度踇外翻患者60例,依据随机数字表法分为干预组、对照组,各30例。干预组给予改良小针刀松解踇收肌联合中医正骨复位治疗,对照组佩戴矫形支具干预。统计分析两组踇外翻角度(HVA)、足外观改善情况、足部功能、相关不良事件发生率、复发情况、下地负重时间及治疗费用。结果治疗当天及治疗4周、8周后,干预组HVA均低于对照组(P<0.05)。治疗后,干预组足外观总改善率为96.67%(29/30),高于对照组的73.33%(22/30)(P<0.05);疼痛、足部对线、关节功能评分及踝关节功能评分(AOFAS)总分均高于对照组(P<0.05);下地负重时间短于对照组,治疗费用低于对照组(P<0.05)。干预组复发率为3.33%(1/30),低于对照组的20.00%(6/30)(P<0.05)。结论改良小针刀松解踇收肌联合中医正骨复位治疗轻中度踇外翻的临床效果较佩戴矫形支具干预效果好。

Objective To study the clinical effect of modified small needle knife releasing adductor hallucis muscle combined with bone setting reduction of traditional Chinese medicine in the treatment of mild to moderate hallux valgus.Methods A total of 60 patients with mild to moderate hallux valgus were randomly divided into intervention group and control group,with 30 cases in each.The HVA angle,foot appearance improvement,foot function,incidence of related adverse events,recurrence,weight bearing time and treatment cost of the two groups were statistically analyzed.Results On the day of treatment and after 4 and 8 weeks of treatment,HVA in the intervention group was lower than that in the control group(P<0.05).After treatment,the total improvement rate of foot appearance in the intervention group was 96.67%(29/30),which was higher than that in the control group(73.33%,22/30)(P<0.05).Pain,foot alignment,joint function score and ankle joint function score(AOFAS)were higher than those of control group(P<0.05).The weightbearing time was shorter than that of control group,and the treatment cost was lower than that of control group(P<0.05).The recurrence rate of intervention group was 3.33%(1/30),which was lower than that of control group(20.00%,6/30)(P<0.05).Conclusion The clinical effect of modified small needle knife releasing the adductor hallucis muscle combined with bone setting reduction of traditional Chinese medicine in the treatment of mild to moderate hallux valgus is better than that of wearing orthopedic brace.