中国骨伤2025，Vol.38Issue(6)：559-565,7.DOI:10.12200/j.issn.1003-0034.20241127
经跖骨间切口与内侧切口外侧软组织松解联合Scarf截骨治疗中重度拇外翻的临床疗效比较
Comparison of clinical efficacy of transmetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy in the treatment of moderate to severe hallux valgus
摘要
Abstract
Objective To compare clinical efficacy of intermetatarsal incision and lateral soft tissue release of medial inci-sion combined with Scarf osteotomy in treating moderate to severe hallux valgus(HV).Methods A retrospective analysis was conducted on clinical data of 42 patients with moderate to severe HV admitted from January 2022 to December 2022.Accord-ing to different incisions,the patients were divided into medial incision group with 22 patients(22 feet)and intermetatarsal in-cision group with 20 patients(20 feet).In medial incision group,there were 3 males and 19 females,aged from 40 to 69 years old with an average of(55.0±11.4)years old;body mass index(BMI)ranged from 21 to 29 kg·m-2 with an average of(25.2±2.1)kg·m-2;the courses of disease ranged from 8 to 16 years with average of(12.0±2.2)years;11 patients with moderate de-formity and 11 patients with severe deformity.In transplantar incision group,there were 3 males and 17 females,aged from 39 to 68 years old with an average of(53.0±7.5)years old;BMI ranged from 20 to 28 kg·m-2 with an average of(24.8±1.9)kg·m-2;the courses of disease ranged from 9 to 17 years with an average of(14.0±3.1)years;9 patients with moderate deformity and 11 patients with severe deformity.Hallux valgus angle(HVA)and the first-second intermetatarsal angle(IMA),American Or-thopaedic Foot and Ankle Society(AOFAS)forefoot scores and complications between two groups before operation and 12 months after operation were observed and compared.Results All patients were successfully completed the surgery and were followed up for 12 to 15 months with an average of(13.52±1.65)months.There were no statistically significant difference in HVA and IMA between two groups before operation and 12 months after operation(P＞0.05).AOFAS forefoot scores of medial incision group before operation and 12 months after operation were(45.0±6.8)and(86.0±6.7)respectively,and those of transmetatarsal incision group were(46.0±7.4)and(83.0±7.5)respectively.Postoperative AOFAS forefoot scores between two groups at 12 months were statistically significant compared with those of before operation(P＜0.01).According to AOFAS fore-foot scores,8 patients got excellent result,14 good in medial incision group;while 6 excellent and 14 good in transplantar inci-sion group.At 12 months,postoperative AOFAS forefoot score of functional score of in medial incision group(38.0±2.5),was better than that in transplantar incision group(34.0±2.2),and the difference was statistically significant(P＜0.05).One patient in medial incision group occurred HV deformity,mild numbness occurred in 3 toes in transplantar incision group,and 3 pa-tients were dissatisfied with scar.No complications such as infection,nonunion of bones or ischemic necrosis of metatarsal heads occurred in either group.Conclusion Both intermetatarsal incision and lateral soft tissue release of medial incision com-bined with Scarf osteotomy can effectively treat moderate to severe HV.The functional recovery after medial incision is better than that after intermetatarsal incision.关键词
拇外翻/Scarf截骨/外侧软组织松解/病例对照研究Key words
Hallux valgus/Scarf osteotomy/Lateral soft tissue release/Case control study分类
医药卫生引用本文复制引用
温丰平,刘行,陈崇阳,田世坤..经跖骨间切口与内侧切口外侧软组织松解联合Scarf截骨治疗中重度拇外翻的临床疗效比较[J].中国骨伤,2025,38(6):559-565,7.基金项目
2023年恩施州"硒引工程"科技项目(编号:D20230028)2023 Enshi Science and Technology Project of"Selenium Diversion Project"(No.D20230028) （编号:D20230028）
