摘要
目的比较Ludloff截骨和跖骨基底斜楔形截骨治疗中、重度拇外翻的近期临床结果。方法 2008年7月至2009年2月,对21例中、重度拇外翻患者(男2例,女19例)29足实行拇外翻矫形手术。Ludloff截骨术7例(11足),基底楔形截骨14例(18足)。采用AOFAS评分对患足进行临床功能评价,同时拍负重位的正侧位X线片进行影像学评价。随访结果使用SPSS10.0统计软件包进行处理。结果随访时间5～13个月。最后一次随访时,23足基本无痛(Ludloff截骨9例,基底斜楔形截骨14例),6足偶有疼痛或轻微疼痛(Ludloff截骨2例,基底斜楔形截骨4例)。有两足拇外翻纠正欠佳(基底斜楔形截骨),但无疼痛症状。18人,26足基本恢复正常活动。3人,3足(其中1人为双侧,但只有1足有症状,Ludloff截骨术1例,基底截骨术2例)在长距离或长时间行走时出现疼痛。术后AOFAS评分平均为83分(58～92分)。患者自我感觉良好的有17人,24足(Ludloff截骨术10例,基底截骨14例);感觉较好的2人,3足;感觉一般的2人,2足(Ludloff截骨术1例,基底截骨1例)。对外形满意的19人,26足(Ludloff截骨术10例,基底截骨16例);一般的1人,1足(Ludloff截骨术);不满意的1人,1足(基底截骨术)。结论两种手术方式都是治疗中、重度拇外翻可靠有效的方法,但最终的临床结果没有显著不同。
Objective To compare the intermediate - term results between Ludloff osteotomy and oblique closing wedge osteotomy in hallux valgus.Methods From July 2008 to February 2009,21 patients（29 feet） were treated by Ludloff osteotomy（7 patients,11 feet） and oblique closing wedge osteotomy（14 patients,18 feet） on the first metatarsal and release on the lateral of the first metatarsophalangeal joint.All of the patients were evaluated with AOFAS scale,radiograph prior to the operation.SPSS are used for statistics.Results At the last follow - up,there are no pain in 23 feet （9 feet in Ludloff group,14 feet in oblique closing wedge group）,6 feet were mild pain（2 feet in Ludloff,4 feet in ob- lique closing wedge）.Two feet were not corrected sufficiently in oblique closing wedge group.Twenty - six feet recovered completely and 3 feet（1 in Ludloff group,2 in oblique closing wedge group） appeared pain after long distance walking. Mean AOFAS was 83°（58～92°） after operations.Conclusion Both Ludloff osteotomy and oblique closing wedge osteotomy are reliable in treating hallux valgus and the clinical results are satisfactory.
出处
《中国骨与关节外科》
2011年第1期36-39,共4页
Chinese Journal of Bone and Joint Surgery
