| 合并第2趾锤状趾与否对拇外翻术后临床疗效的影响 |
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Received:January 26, 2025
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| 作者 | Author | 单位 | Unit | E-Mail |
| 田竞 |
TIAN Jing |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 韩天宇 |
HAN Tian-yu |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
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| 解冰 |
XIE Bing |
北部战区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, General Hospital of Northern Theater Command, Shenyang 110016, Liaoning, China |
302200400116@163.com |
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| 期刊信息：《中国骨伤》2025年38卷，第6期，第553-558页 |
| DOI：10.12200/j.issn.1003-0034.20240149 |
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目的：比较Ludloff手术治疗是否合并第2趾锤状趾对拇外翻患者术后临床疗效的影响。
方法：回顾性分析2015年7月至2022年7月采用Ludloff手术治疗的66例拇外翻患者的临床资料。根据纳排标准,最终纳入33例拇外翻合并锤状趾患者作为病例组,配对选择33例单纯拇外翻患者作为对照组。病例组男11例,女22例;年龄24~62(33.6±12.7)岁;身体质量指数(body mass index,BMI)为19~25(21.7±3.1) kg·m-2;左侧17例,右侧16例;拇外翻角(hallux valgus angle,HVA)为25°~47°(36.3±10.2)°;第1-2跖骨间角(intermetatarsal angle,IMA)为13°~21°(16.9±3.2)°。对照组男12例,女21例;年龄22~61(32.2±10.9)岁;BMI为18~26(22.0±4.2) kg·m-2;左侧15例,右侧18例;HVA为26°~46°(37.2±9.3)°;IMA为12°~21°(17.3±4.7)°。比较两组围术期切口并发症、骨愈合及畸形复发情况。比较两组术后3、6、12个月HVA、IMA、美国骨科学会足踝外科学会(American Orthopadic Foot and Ankle Society,AOFAS)前足评分及疼痛视觉模拟评分(visual analog scale,VAS)的变化情况。
结果：两组均完成术后1年的随访。病例组术后2例切口皮缘坏死,对照组术后1例切口裂开,两组比较差异无统计学意义(χ2=0.058,P>0.05)。两组术后12周时均获得Ⅰ期骨愈合,随访期间无拇外翻复发。术后3个月,病例组AOFAS前足评分(73.4±8.6)分,低于对照组(82.1±10.3)分,差异有统计学意义(t=2.273,P<0.05)。术后6、12个月,两组HVA、IMA、AOFAS前足评分和VAS比较,差异均无统计学意义(P>0.05)。
结论：采用Ludloff手术治疗合并第2趾锤状趾的拇外翻患者术后早期功能恢复较慢,但并不影响患者术后的长期临床疗效。 |
| [关键词]:拇外翻 Ludloff 手术 锤状趾 病例对照研究 |
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| Influence of the presence or absence of the second hammertoe on clinical effect of hallux valgus |
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Abstract:
Objective To compare clinical effect of Ludloff operation on the clinical efficacy of patients with hallux valgus combined with hammertoe of the second toe.
Methods The clinical data of 66 patients with hallux valgus treated with Ludloff surgery from July 2015 to July 2022 were retrospectively analyzed. According to exclusion criteria,33 patients with hallux valgus combined with hammertoe were finally included as case group,and 33 patients with simple hallux valgus were paired as control group. There were 11 males and 22 females in case group,aged from 24 to 62 years old with an average of (33.6±12.7) years old;body mass index (BMI) ranged from 19 to 25 kg·m-2 with an average of (21.7±3.1) kg·m-2;17 patients on the left side and 16 patients on the right side;hallux valgus angle (HVA) ranged from 25° to 47° with an average of (36.3±10.2) °;the intermetatarsal angle (IMA) ranged from 13° to 21° with an average of (16.9±3.2) °. There were 12 males and 21 females in control group,aged from 22 to 61 years old with an average of (32.2±10.9) years old;BMI ranged from 18 to 26 kg·m-2 with an average of (22.0±4.2) kg·m-2;15 patients on the left side and 18 patients on the right side;HVA ranged from 26° to 46° with an average of (37.2±9.3) °;IMA ranged from 12° to 21° with an average of (17.3±4.7) °. HVA,IMA,American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores and visual analogue scale (VAS) were compared at 3,6 and 12 months after operation between two groups.
Results Both groups were completed 1 year postoperative follow-up. Postoperative cutaneous margin necrosis occurred in 2 patients of case group and incision rupture occurred in 1 patient of control group. There was no significant difference between two groups (χ2=0.058,P>0.05). Both groups were achieved bone union at stageⅠ at 12 weeks after opertaion,and no recurrence of bunion was observed during follow up. Three months after operation,AOFAS forefoot function score of case group was (73.4±8.6),which was lower than that of control group (82.1±10.3),and the difference was statistically significant (P<0.05). There were no significant differences in HVA,IMA,AOFAS and VAS between two groups at 6 and 12 months after operation (P>0.05).
Conclusion Ludloff surgery for the treatment of bunions with malleform toe of the second toe is slow in the early postoperative functional recovery,but it did not affect the long-term clinical outcome of the patients. |
| KEYWORDS:Hallux valgus Ludloff procedure Hammer toe Case-control study |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 田竞,韩天宇,解冰.合并第2趾锤状趾与否对拇外翻术后临床疗效的影响[J].中国骨伤,2025,38(6):553~558 |
| 英文格式: | TIAN Jing,HAN Tian-yu,XIE Bing.Influence of the presence or absence of the second hammertoe on clinical effect of hallux valgus[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(6):553~558 |
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