改良Keller手术联合可吸收棒治疗中重度老年性外翻的疗效分析
发布时间：2018-09-06 10:54
【摘要】：[目的]回顾分析改良Keller手术联合可吸收棒治疗中/重度老年性鐷母外翻的应用疗效。[方法]对中重度老年性鐷母外翻患者采用改良Keller手术以"V"型截骨方法切除第一跖骨远端、趾骨近段多余骨赘,同时术中紧缩内侧关节囊,切断内收肌,截骨端以可吸收棒交叉固定第一跖趾关节,术后辅以短腿石膏固定4周。[结果]23例(33足),随访6~20个月,平均13个月。患足伤口除2例出现组织液化坏死,后经换药/理疗等处理痊愈,余31足皆一期愈合,1例(1足)诉偶有疼痛外,其他均无不适感,鐷母外翻角(HVA)平均改善(15.89±4.52)°;第1、2跖骨间角(IMA)平均改善(7.90±1.25)°,与术前HVA和IMA相比明显减小,差异有统计学意义(P≤0.05);美国足踝外科协会鐷母趾-跖趾-趾间关节评分由术前的(69.28±6.71)分提高到术后的(93.05±6.72)分(P≤0.05)。[结论]改良Keller手术联合可吸收棒治疗中/重度鐷母外翻的疗效可靠,尤其对老年性患者适用,可避免金属物对软组织的刺激,安全有效,避免了二次手术取出内固定给老年患者带来的痛苦。
[Abstract]:Objective: to retrospectively analyze the effect of modified Keller operation combined with absorbable rod in the treatment of moderate / severe senile valgus. [methods] A modified Keller procedure was used to remove the distal first metatarsal bone and redundant proximal phalangeal osteophyte in patients with moderate and severe senile valgus. Meanwhile, the medial articular capsule was constricted and adductor muscle was cut off during the operation. The first metatarsophalangeal joint was cross-fixed with absorbable rod at the end of osteotomy and was fixed with short leg plaster for 4 weeks. [results] 23 cases (33 feet) were followed up for 6 ~ 20 months (mean 13 months). Except for 2 cases of tissue liquefaction and necrosis, which were cured by dressing change / physiotherapy, 31 feet were healed in one case (1 foot) with occasional pain, and no discomfort was found in all the other cases. The mean improvement of (HVA) and (IMA) were (15.89 卤4.52) 掳and (7.90 卤1.25) 掳, respectively. Compared with those before operation, HVA and IMA decreased significantly. There was a significant difference (P 鈮，
本文编号：2226135
[Abstract]:Objective: to retrospectively analyze the effect of modified Keller operation combined with absorbable rod in the treatment of moderate / severe senile valgus. [methods] A modified Keller procedure was used to remove the distal first metatarsal bone and redundant proximal phalangeal osteophyte in patients with moderate and severe senile valgus. Meanwhile, the medial articular capsule was constricted and adductor muscle was cut off during the operation. The first metatarsophalangeal joint was cross-fixed with absorbable rod at the end of osteotomy and was fixed with short leg plaster for 4 weeks. [results] 23 cases (33 feet) were followed up for 6 ~ 20 months (mean 13 months). Except for 2 cases of tissue liquefaction and necrosis, which were cured by dressing change / physiotherapy, 31 feet were healed in one case (1 foot) with occasional pain, and no discomfort was found in all the other cases. The mean improvement of (HVA) and (IMA) were (15.89 卤4.52) 掳and (7.90 卤1.25) 掳, respectively. Compared with those before operation, HVA and IMA decreased significantly. There was a significant difference (P 鈮，
本文编号：2226135
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