经内侧切口行外侧软组织松解联合Austin、Akin截骨术治疗中度外翻

张圣兵，张洪涛，钮俊杰，李俊坤，王根林，杨惠林

(1.江苏省无锡市第二中医医院骨科，江苏 无锡　214121；2.苏州大学附属第一医院骨科，江苏 苏州　215006)



张圣兵1，张洪涛2*，钮俊杰2，李俊坤2，王根林2，杨惠林2

(1.江苏省无锡市第二中医医院骨科，江苏 无锡214121；2.苏州大学附属第一医院骨科，江苏 苏州215006)

1　资料与方法

2　结　　果

表1　患者术前、术后的HVA、IMA、AOFAS前足评分结果比较

表2　患者术前、末次随访的HVA、IMA、　AOFAS前足评分结果比较

3　讨　　论

图1术前大体照示术前左足外翻畸形图2术中大体照示经内侧切口通过关节间隙行外侧软组织松解图3术后大体照示左足畸形已矫正

图4术前X线片示左足HVA、IMA明显增大图5术后X线片示左足HVA、IMA已恢复正常

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Lateral Soft Tissue Release Combined with Austin and Akin Osteotomy Using Medial Approach for the Treatment of Moderate Hallux Valgus

Zhang Shengbing1，Zhang Hongtao2*，Niu Junjie2

(1.Department of Orthopaedics，The Second Chinese Medicine Hospital of Wuxi ，Wuxi 214121；2.Department of Orthopaedics，First Affiliated Hospital of Soochow University，Suzhou 215006，China)

ObjectiveTo analyze the therapeutic effect of lateral soft tissue release combined with Austin and Akin osteotomy using medial approach for the treatment of moderate hallux valgus.MethodsWe retrospectively analyzed 30 patients with 33 feet of moderate hallux valgus who were treated by lateral soft tissue release combined with Austin and Akin osteotomy using medial approach from January 2013 to May 2015.All the patients underwent anteroposterior X-ray images in weight loading of involved feet to measure hallux valgus angle (HVA) and intermetatarsal angle (IMA) preoperatively and postoperatively.The function of involved feet were evaluated using front foot scoring system of American Orthopaedic Foot and Ankle Society (AOFAS) preoperatively and postoperatively.ResultsAll the patients were followed up for an average of 13.9 months (ranged from 6 to 25 months).Only one patient was performed second metatarsal Weil osteotomy due to transferred plantalgia postoperatively，other 29 patients were all very satisfied with the surgery.No dorsalis pedis numbness，hallux varus，metatarsal transferred pain，nonunion or recurrence of hallux valgus was presented.HVA was corrected from (33.5±6.4)° preoperatively to (11.0±4.5)° postoperatively (P<0.05).IMA (from 13.6±2.5° to 7.4±2.3°，P<0.05) and AOFAS score (from 39±8.5 to 87±9.3，P<0.05) were also improved postoperatively.ConclusionLateral soft tissue release combined with Austin and Akin osteotomy using medial approach is effective in treating moderate hallux valgus.It can also prevent formation of dorsalis pedis scars and damage of local cutaneous nerves and vessels.

medial approach；soft tissue release；osteotomy；hallux valgus

1008-5572(2016)08-0693-04

R687.3

B

2016-02-16

张圣兵(1973- )，男，副主任医师，江苏省无锡市第二中医医院骨科，214121。

*本文通讯作者：张洪涛