一期延长髂骨植骨治疗第一跖骨短小症

Treatment of first metatarsal shortness with one-stage prolongation bone graft

目的探讨一期延长髂骨植骨治疗第一跖骨短小症的临床疗效,并介绍该手术方式的优点。方法采用第一跖骨背侧切口,于跖骨中段用摆锯将跖骨截断,一期延长取髂骨植骨。结果本组5例患者获术后随访6～18个月,术后12周时X线片示5例跖骨均达到骨性愈合,延长长度1.2～2.2 cm,平均1.7 cm。按照美国足踝矫形外科协会(American orthopedic foot and ankle society, AOFAS)的功能评判标准,术后AOFAS评分平均为87.5分,3例优,2例良。无明显并发症发生,所有患者对延长结果、外形及足功能恢复满意或基本满意。结论一期延长髂骨植骨治疗第一跖骨短小症能使跖骨恢复到满意的长度,且恢复较快,并发症较少,值得临床推广应用。

Objective To explore the clinical efficacy of one-stage prolongation bone graft in the treatment of first metatarsal shortness and to introduce the advantages of this surgical method.Methods The middle part of the metatarsal bone was cut off with a swing saw through the dorsal incision of the first metatarsal bone.The iliac bone was obtained for one-stage prolongation bone graft.Results All patients were followed up from 6 to 18 months.The postoperative radiographs showed that bony union was achieved in all metatarsals at 12 weeks.The average prolongation length was 1.7 cm(from 1.2 to 2.2 cm).Function was evaluated according to the standard of the American Orthopedic Foot and Ankle Society(AOFAS).The average postoperative AOFAS score was 87.5,3 were excellent,and 2 were good.No obvious complications were found.All patients were satisfied with the prolongation results,appearance,and recovery of function in the feet.Conclusion Treatment of first metatarsal shortness with one-stage prolongation using iliac bone graft can restore the metatarsal bone to a satisfactory length.This method has a short recovery period,and complications are rare,making this procedure worth popularizing and applying in clinic.