骨折内固定_____⻊母外翻；_骨折内固定；

改良Mitchell手术治疗⻊母外翻

http://www.100md.com 《中国矫形外科杂志》 2006年第5期

骨折内固定,,⻊母外翻；,骨折内固定；,治疗结果,1资料与方法,2结果,3讨论,参考文献：

     摘要：[目的]观察改良Mitchell手术治疗⻊母外翻的疗效。[方法]自2000年4月~2003年10月对18例28足⻊母外翻患者行改良Mitchell手术。术前摄负重X线片，测量⻊母外翻角(hallux valgus angle,HVA)平均为305°，第1、2跖骨间角(Intermetatarso-phalangeal angle,IMA)135°。本术式与传统Mitchell手术不同的是在第1跖骨远端只行一次横行截骨，不留外侧棘，根据IMA的大小决定截骨远端外移的多少，再向跖侧移位2~3 mm，用可吸收螺钉固定。[结果]随访28足，随访时间为10~32个月，优24足，良3足，差1足，优良率为929%。术后负重X线片测量HVA 155°，平均改善15°；IMA平均为85°，平均改善5°。[结论]改良Mitchell手术可矫正第1跖骨内翻，更重要的在于矫正畸形而不破坏⻊母趾的生物力学作用，第1跖骨头的跖侧移位，重建了足横弓，恢复了⻊母趾的负重功能。

    关键词：⻊母外翻；骨折内固定；治疗结果

    Treatment of hallux valgus with modified Mitchell operation∥WANG Wei,WANG Jianfeng,HAO Hua,et alOrthopedic Department,General Hospital of Armed Police,Beijing 100027

    Abstract：[Objective]To observe the effect of treating hallux valgus with modified Mitchell operation[Method]A total of 18 cases ( 28 feet ) of hallux valgus were treated with modified Mitchell operation from Apr2000 to Oct2003The average preoperative hallux valgus angle (HVA) was 305 according to the Xray images,while the average intermetatarsophalangeal angle (IMA) was 135The difference between the modified Mitchell operation and normal one was that only one transverse osteotomy need to be carried out in the distal metatarsal without lateral ridge leftThe distal position of osteotomy was extended according to the sum of IMA and then moved to the metatarso side by 2~3 mmAbsorbable screws were used for fixation[Result]All 28 feet were followed up for 10~32 monthsIt showed excellent result in 24 feet,good in 3,and bad in 1,with the total satisfactory rate of 929%According to the postoperative weightloading Xray checking result,the average HVA was 155,with an average improving of 15 ; the average IMA was 85,with an average improving of 5[Conclusion]The modified Mitchell operation can correct the metatarsovarus without destroying the biomechanical statusThe loading function of great toe could be resumed by the removing of the first metatarso head ......

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