【作者】 吴鹏飞；

【导师】 王培民；

【作者基本信息】 南京中医药大学 ， 中医骨伤科学， 2012， 硕士

【摘要】 目的：观察chevron截骨术治疗拇外翻的近期疗效。方法：选取江苏省中医院骨伤科2010年1月至2012年3月间符合拇外翻诊断标准的患者14例,共20足,采用chevron截骨术治疗,在手术前后拍摄负重位X线片,测量拇外翻角(HAV),第1、2跖骨间角(IMA)及近端关节面固定角(PASA),根据Mann分型将患者分为轻度拇外翻、中度拇外翻、重度拇外翻,应用AOFAS评分量表对患者进行评分。采用SPSS19.0软件对相关数据进行统计分析。结果：1.手术前后进行功能评分,AOFAS评分由47.60±7.05分上升至81.20±4.58分。经统计学分析(P<0.05),具有统计学意义。2.手术前后负重正位X线片测量,平均FIVA由32.45。减至11.38。,IMA由11.60。减至6.09°, PASA由19.12。减至8.18。,各指标在手术前后对比均有统计学差异(P<0.05)。3.无论是轻度拇外翻、中度拇外翻,还是重度拇外翻的患者,术后X线片测量结果与AOFAS量表评分值均与术前差异明显,P<0.05,有统计学意义。4.患者术后近期均取得较满意疗效,无患者因手术效果不满意而要求再次手术。结论：1. Chevron截骨术治疗拇外翻的近期疗效确切,在矫正畸形,缓解疼痛,患者自我满意度等方面,疗效满意,是临床治疗拇外翻的一种常用方法。2.拇外翻的异常解剖结构在手术以后得到恢复,重建了力学平衡。其负重位X线测量及功能评分对术前指导及手术疗效的评估有重要意义。更多还原

【Abstract】 Objective:To explore the chevron technique for treatment of hallux valgus. Methods:chevron osteotomies were performed on20feet in14patients during2010.1-2012.3.Before and after operation in shooting weight a X-ray measurement hallux valgus Angle (HAV),1,2metatarsal Angle between (IMA),and proximal articular surface fixed Angle (PASA), according to Mann classification will patients into mild hallux valgus, moderate, and severe hallux valgus hallux valgus, application AOFAS rating scale rating to patients. The SPSS19.0software related data of statistical analysis. Results:1.AOFAS seore was47.607.05while81.20±4.58Preoperatively. The Parameters are of statistieal signifieanee.2.ComPared with the PreoPerative weight bearing X-ray measurement, HVA was redueed to11.38°from32.45°, IMA was6.09°from11.60°, PASA was8.18°form19.12°The Parameters are of statistieal signifieanee.3.Whether mild, moderate hallux valgus hallux valgus, or severe hallux valgus patients, postoperative X-ray measurement results and AOFAS rating scale value are significant difference with preoperative, P<0.05, with a statistical significance.4.Hallux valgus postoperative patients are satisfied with curative effect, no patients for operation results are not satisfactory and require a second surgery. Conclusions:1. Chevron osteotomy hallux valgus treatment of recent symptoms, and in the correct deformity, pain, patients self satisfaction, etc, and the results were satisfactory, is the clinical treatment of hallux valgus a common method.2.After the operation restoration hallux valgus abnormal in anatomical structure, rebuilt the mechanics balance. A full load of hallux valgus X line measurement and functional score for preoperative guidance and the effectiveness of surgery to have the important meaning.更多还原