生物骨科材料与临床研究2024，Vol.21Issue(3)：53-57,63,6.DOI:10.3969/j.issn.1672-5972.2024.03.010
改良Lapidus截骨术第1跖楔关节单平面截骨联合第1跖骨下移治疗拇外翻的疗效分析
Analysis of the efficacy of the modified Lapidus arthrodesis with single planar osteotomy of the first metatarsocuneiform joint combined with moving down the first metatarsal for the treatment of hallux valgus
李大成 1王青松 1宋传航 1付莹 1靳晓波1
作者信息
- 1. 承德市中心医院骨科,河北 承德,067024
- 折叠
摘要
Abstract
Objective To analyze the effect of the modified Lapidus arthrodesis with single planar osteotomy of the tarsometatarsal joint combined with first metatarsal inferior displacement for hallux valgus.Methods A total of 27 patients(34 feet)with moderate to severe hallux valgus who received modified Lapidus arthrodesis from September 2018 to September 2021 were selected at Chengde Center Hospital.All patients underwent preoperative weighted radiographs,1 week postoperative unweighted radiographs,and follow-up foot weighted radiographs to measure the first metatarsal length(FML),the hallux valgus angle(HVA),the intermetatarsal angle(IMA),the tibial sesamoid position(TSP),the height of the base of the 1st metatarsal from the ground and the angle of the 1st metatarsal and the ground.The clinical efficacy of the operation was evaluated according to the American Orthopedics Foot and Ankle Society(AOFAS)and visual analogue scale(VAS).Statistical analysis was performed on the above data.Results All patients underwent successful surgery and were followed up for 12 to 48 months.There was no significant difference in FML at the first week after surgery,at the last follow-up and before surgery(P>0.05).For HVA,IMA and TSP,there was a decrease at 1 week after surgery and at the last follow-up compared to before surgery,the differences were statistically significant(P<0.05),but there was no significant change between 1 week after surgery and the last follow-up(P>0.05).In terms of the height of the first metatarsal base from the ground,the angle between the first metatarsal and the ground and the VAS score,the last follow-up was lower than that before surgery,and the differences were statistically significant(P<0.05).For the AOFAS score,the last follow-up was higher than that before surgery,and the difference was statistically significant(P<0.05).All patients had no complications such as metastatic pain,and some patients showed increased imaging angles.Conclusion The single plane osteotomy of the first metatarsal wedge joint combined with the descending of the first metatarsal bone can not only guarantee the effect of surgical treatment,but also effectively prevent the postoperative pain and other complications caused by the shortening and angulation of the first metatarsal bone caused by the traditional Lapidus double plane osteotomy,which is worth promoting.关键词
第1跖楔关节/拇外翻/Lapidus术/单平面截骨Key words
First metatarsocuneiform joint/Hallux valgus/Lapidus arthrodesis/Single planar osteotomy分类
医药卫生引用本文复制引用
李大成,王青松,宋传航,付莹,靳晓波..改良Lapidus截骨术第1跖楔关节单平面截骨联合第1跖骨下移治疗拇外翻的疗效分析[J].生物骨科材料与临床研究,2024,21(3):53-57,63,6.
