第一跖骨颈移位截骨术矫治严重外翻畸形的远期疗效

Long-term Results of the First Metatarsal Neck Displacing Osteotomy in Treating Severe Hallux Valgus

目的:观察第一跖骨颈移位截骨术纠正第一序列畸形的远期疗效。方法:采用第一跖骨颈内侧骨突切除和第一跖骨颈外移截骨术,矫治严重(足母)外翻畸形,使第一序列成一直线排列。结果:平均随访5年以上,从畸形纠正、疼痛、负重功能、X线片和复发情况综合评价疗效。90％病人无痛、负重功能好、足形美观、畸形无复发。结论:研究(足母)外翻畸形时,必须重视足第一序列解剖异常,以正确选择术式。第一跖骨颈移位截骨纠正严重(足母)外翻畸形远期疗效满意,值得推广。

Objective: To explore the long-term results of the first metatarsal neck displacing osteotomy for the correction of complex deformity of the first ray. Methods: A technique of removal of the medial eminence combined with the lateral displacing osteotomy in the first metatarsal neck was employed, in 35 patients(50 feet), to correct the hallux valgus-first metatarsal deformity, and to restore the straight line of the first ray. Likewise , the accompanied lesser toe bunion was also treated surgically using the similar method. Results; The average follow-up time were over 5 years. The clinical outcomes were critically evaluated by analysis of the extent of deformity correction, the severity of pain, the function of weight bearing , the measure of plain radiographs, a standardized clinical questionnaire, and physical examination and the incidence of recurrence. It was found that 90% of the patients got a pain free, cosmetically satisfactory foot with excellent weight bearing function and no deformity recurrence. Conclusions: While studying the hallux valgus, special attention should be paid to the abnormality of the first ray so as to choose the correct surgical method. Lateral displacing osteotomy of the first metatarsal neck is an excellent method to be used properly and its wide application is strongly recommended.