【摘要】 目的 探讨联合截骨治疗青少年外翻畸形的疗效分析。方法 回顾性分析2008年1月至2015年1月河北医科大学第三医院收治的联合截骨治疗青少年外翻100例(185足)患者的临床资料,其中男48例(88足),女52例(97足),年龄11~19岁,平均(15.5±3.48)岁,随访时间为18~48个月,平均(28.5±6.8)个月。手术前后均摄双足负重正侧位X线影响检查,术前测量外翻角为35°~65°,平均(49.61±14.25)°,第1、2跖骨间角15°~27°,平均(21.03±6.73)°。手术方法采用第1跖骨基底或跖骨干加第1跖骨颈截骨钢板固定或近节趾骨基底截骨克氏针固定。根据不同患者外翻的症状矫正软组织平衡,必要时松解内收肌。采用AOFAS评分评价临床疗效。结果 85例(157足)获得随访,患者外翻角为(18.18±4.55)°,第1、2跖骨间夹角为(5.07±1.70)°,平均矫正30.54°和17.33°,术后,足部评分(84.8±7.6)分,与治疗前的(46.5±9.4)分相比,差异有统计学意义(P<0.05)。结论 青少年外翻以遗传为主,外翻严重。采用联合截骨位治疗青少年外翻,可矫正第1跖骨内翻同时矫正远端关节固角,提高矫正效果,降低复发率。更多还原

【Abstract】 Objective To discuss the curative effect of combined osteotomy on adolescent hallux valgus deformity. Methods This study was conducted in a retrospective manner. 100 patients(185 ankles) presenting to our institution with a hallux valgus deformity and treated with combined osteotomy between 2008 and 2015. 48 of the 100 patients(88 feet)were men and 52 were women(97 feet).The average age at surgery was(15.5±3.48) years(range, 11-19 years).Median follow-up duration was(28.5±6.8) months(range, 18-48 months). Standing anteroposterior and lateral radiographs were taken preoperatively and during the final follow ups. The mean preoperative hallux valgus angle(HVA),intermetatarsal angle(IMA) angle were(49.61±14.25)degrees(range,35-65 degrees),(21.03±6.73)degrees(range,15-27 degrees).Outcomes were assessed by comparison of preoperative and postoperative American Orthopaedic Foot and Ankle Society(AOFAS) scores.Surgical methods using the first metatarsal base or metatarsal plus primary metatarsal neck osteotomy or proximal toe bone base osteotomy plate fixation. According to the symptoms of different patients with hallux valgus correction of soft tissue balance, if necessary, release the adductor muscle. Results Postoperative 85 patients(157 feet) were followed up, The mean postoperative HVA, IMA,were(18.18±4.55)° degrees,(5.07±1.70)°, the average corrected 30.54 degrees and 17.33 degrees,the AOFAS Score(84.8 ± 7.6). Conclusion Adolescent Hallux Valgus is mainly inherited,The combined osteotomy is an effective treatment of Adolescent Hallux Valgus. The procedure effectively corrects the the first metatarsal varus and the DMAA,it can improve the correction effect, reduce the recurrence rate.更多还原