文章摘要
何兵,杜斌,孙光权,等.Chevron联合Akin截骨与Scarf联合Akin截骨治疗中度足母外翻的临床疗效对比.骨科,2019,10(3): 205-209.
Chevron联合Akin截骨与Scarf联合Akin截骨治疗中度足母外翻的临床疗效对比
Clinical efficacy of Chevron combined with Akin osteotomy vs. Scarf combined with Akin osteotomy in the treatment of moderate hallux valgus
投稿时间:2018-12-03  
DOI:10.3969/j.issn.1674-8573.2019.03.008
中文关键词: 足母外翻  Scarf截骨  Chevron截骨  Akin截骨
英文关键词: Hallux valgus  Scarf osteotomy  Chevron osteotomy  Akin osteotomy
基金项目:
作者单位E-mail
何兵 南京中医药大学南京 210023  
杜斌 江苏省中医院骨伤科南京 210023 dubin67@sina.com 
孙光权 南京中医药大学南京 210023  
刘锌 南京中医药大学南京 210023  
彭晨健 江苏省中医院骨伤科南京 210023  
于恒恒 江苏省中医院骨伤科南京 210023  
薛鹏 江苏省中医院骨伤科南京 210023  
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中文摘要:
      目的 比较Chevron联合Akin截骨术与Scarf联合Akin截骨术治疗中度足母外翻的临床疗效。方法 回顾分析江苏省中医院骨伤科2012年9月至2015年9月收治的27例(36足)中度足母外翻病人,Chevron联合Akin截骨组(CA组)14例(19足),Scarf联合Akin截骨组(SA组)13例(17足),比较两组术前、术后1个月、1年及末次随访时以下指标:足母外翻角(hallux valgus angle, HVA);第1、2跖骨间夹角(inter metatarsal angle, IMA);近端关节面固有角(distal metatarsal articular angle, DMAA);胫侧籽骨位置;第一跖骨长度;另外,比较两组术前、术后末次随访的美国足踝外科协会(American Orthopaedic Foot and Ankle Society, AOFAS)评分。两组病人性别、年龄、术前HVA、IMA、DMAA、第一跖骨长度、胫侧籽骨位置的差异均无统计学意义(P均>0.05)。结果 两组病人术中未见明显的并发症,术后均愈合良好,无骨折不愈合、延迟愈合、跖骨头坏死、皮神经损伤、内固定松动、僵直、足母内翻等并发症。术后末次随访CA组AOFAS评分为(93.91±9.03)分,SA组AOFAS评分为(91.83±13.58)分,两组比较,差异无统计学意义(t=0.552,P=0.593)。术后1个月、1年、末次随访时两组的HVA、IMA、DMAA比较,差异均无统计学意义(P均>0.05)。与SA组比较,术后1个月、1年、末次随访时CA组第一跖骨长度短缩程度更大,第一跖骨疼痛发生率更高,而胫侧籽骨复位更理想(P均<0.05)。结论 Chevron联合Akin截骨与Scarf联合Akin截骨治疗中度足母外翻均有较好的疗效,临床疗效相近。
英文摘要:
      Objective To compare the clinical efficacy of Chevron combined with Akin osteotomy vs. Scarf combined with Akin osteotomy for treating moderate hallux valgus. Methods A retrospective analysis was performed on 27 cases (36 feet) of moderate hallux valgus treated in our hospital, including 14 cases (19 feet) undergoing Chevron combined with Akin osteotomy group (CA group), and 13 cases (17 feet) undergoing Scarf combined with Akin osteotomy group (SA group). The hallux valgus angle (HVA), inter metatarsal angle (IMA), distal metatarsal articular angle (DMAA), medial hallux sesamoid position, the first metatarsal length before operation, 1 and 12 months after operation, and at the last follow-up were compared between the two groups, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot function score systems were also compared between two groups before operation and at last follow-up. There was no significant difference in gender, age, preoperative HVA, IMA, DMAA, the first metatarsal length, and medial hallux sesamoid position between the two groups. Results There were no obvious complications in the two groups during the operation, and no complications such as nonunion of fracture, delayed union, metatarsal head necrosis, cutaneous nerve injury, loosening of internal fixation, stiffness and inversion occurred. At the last follow-up, the AOFAS score in CA group was (93.91±9.03) and (91.83±13.58) in SA group respectively. There was no significant difference between the two groups (t=0.552, P=0.593). Postoperative radiological examination showed that there was no significant difference in HVA, IMA and DMAA between the two groups (all P>0.05). The shortening degree of the first metatarsal was larger, the pain incidence of the first metatarsal was higher, and the medial hallux sesamoid reduction was more ideal in the CA group than in the SA group (all P<0.05). Conclusion Both Chevron combined with Akin osteotomy and Scarf combined with Akin osteotomy have satisfactory curative effects in the treatment of moderate hallux valgus with similar clinical results.
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