【摘要】 背景:外翻是老年人常见的前足疾病,其手术方法超过130种,但是目前对于手术矫正籽骨位置的重要性尚存争议。目的:探讨改良Lapidus手术中对第一跖骨籽骨系统恢复的必要性和有效性。方法:本组21例(29足)外翻患者,均为女性,年龄46～71岁,平均60.3±9.6岁。常规测量术前、术后外翻角(HVA),第一、二跖骨间角(IMA),胫侧籽骨位置(TSP),胫侧籽骨到第二跖骨轴线的距离与第二跖骨长度的比值,分析TSP与外翻的相关性以及手术对于恢复TSP的效果。结果:对于外翻足,与HVA及IMA明显相关,术后患足TSP显著减小。手术前后籽骨的绝对位置无显著性差异。TSP结论:改良Lapidus手术可以有效地恢复第一跖骨籽骨系统,术前应常规评估TSP。更多还原

【Abstract】 Background: Hallux valgus is a common forefoot disease in elder people. More than 130 procedures were used to correct the deformity. But there has been much debate on the importance of correcting the position of the sesamoid bones. Objective: The aim of the study is to explore the efficiency and essentiality of modified Lapidus arthrodesis to the first meta- tarsal-sesamoid system in hallux valgus. Methods: Twenty-one female patients with 29 hallux valgus feet were enrolled in this study. The age of the patients ranged from 46 to 71 years(60.3±9.6 years). Hallux valgus angle(HVA), intermetatarsal angle(IMA)and tibial sesamoid position (TSP)were measured before and after the modified Lapidus arthrodesis. The results were statistically analyzed to explore the relationship between the hallux valgus and TSP and the outcome of modified Lapidus arthrodesis in the correction of TSP. Results: TSP was significantly correlated with HVA and IMA. TSP was redressed by operation. There was no significant dif- ference in the absolute position of sesamoid bones before and after the operation. Conclusions: Modified Lapidus arthrodesis can effectively correct the first metatarsal-sesamoid system. TSP should be used for routine evaluation before surgical procedures of hallux valgus.更多还原