第一跖趾关节融合术后16例患者第1、2跖骨间角的改变及随访评分(1)
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[摘要]目的：随访并研究第1跖趾关节融合术后第1、2跖骨间角(IMA)角的变化。方法：行第1跖趾关节融合术患者12例，患足16例，均为女性。平均年龄(59.0±7.52)岁，平均随访23.1个月。对比患者术前、术后8周负重后以及12个月之后最后1次随访的足正侧位IMA角度变化。最后对患者进行美国足踝矫形协会的足踝评分(AOFAS评分)和手术满意度调查。结果：术前平均IMA角为(13.38±4.21)°，术后8周时平均IMA角为(12.13±3.65)°，两者比较差异无统计学意义(P>0.05)；12个月之后随访时的IMA角缩小至(9.88±1.93)°，较术前比较差异有统计学意义(P<0.05)。术后最后平均AOFAS得分为(74.13±10.95)分，较术前明显提高(P<0.05)。所有患者对手术效果满意。结论：第1跖趾关节融合术后第1、2跖骨间角明显减小，对于术前第1、2跖骨间角较大的患者也不需行手术进一步处理内翻的跖骨。术后IMA缩小，但是并不一定达到正常的角度以下。第1跖趾关节融合可以减少第1、2跖骨间夹角，但是并不一定能使IMA角达到正常的范围以内。
[关键词] 第1跖趾关节融合术；第1、2跖骨间角；手术治疗
[中图分类号] R684 [文献标识码] B [文章编号] 1673-7210(2012)01(a)-149-03
Review of the results and intermetatarsal angle changing after first metatasophalangeal joint arthrodesis in 16 patients
SUN Chao, WANG Zhi, ZHANG Jianzhong
Department of Foot and Ankle Surgery, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing 100730, China
[Abstract] Objective: To study the intermetatasal angle (IMA) changing after first metatasophalangeal arthrodesis. Methods: 12 patients (16 feet) had first metatasophalangeal arthrodesis. All patients were female, with the average age (59.0±7.52) years old. The mean follow-up period was 23.1 months. Measurements included the IMA of the preoperative, 8 weeks post-operative and after 12 months of surgery in final follow-up. Results: The IMA was (13.38±4.21)° before surgery. 8 weeks later after surgery, the average IMA was (12.13±3.65)°, which had no statistic significance (P>0.05). In the final follow-up, which was beyond 12 months after surgery, the average IMA was significantly reduced to (9.88±1.93)° (P<0.05). The mean AOFAS score in final follow-up was (74.13±10.95) scores, which improved significantly(P<0.05). All patients were satisfied with the surgery. Conclusion: IMA is reduced after the first metatasophalangeal arthrodesis. Patients who have severe IMA do not need additional surgery for the varus first metatarsal during the arthrodesis procedure. But the IMA may not as small as a normal one. First metatasophalangeal arthrodesis changes the IMA significantly, but does not reduce it to a normal IMA.
[Key words] First metatasophalangeal arthrodesis; Inter-metatasal angle; Surgical treatment
第一跖趾关节融合术是用于治疗严重拇外翻合并第1跖趾关节骨性关节炎及类风湿性关节炎的手术方式之一。第1跖趾关节融合术最早由Broca在1852年报道。手术适应证有拇僵直症、第1跖趾关节骨性关节炎 ......
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