改良单螺钉Scarf截骨矫正母外翻畸形△

Modified single-screw Scarf osteotomy for hallux valgus

摘要:

[目的]探讨改良单螺钉 Scarf 截骨治疗母外翻的临床疗效。[方法]回顾性分析 2020 年 6 月—2021 年 2 月作者采用改良单螺钉 Scarf 截骨母外翻 23 例(30 足)，记录临床及影像结果。[结果]所有患者均顺利完成手术，术中无血管、神经损伤等并发症发生。手术时间平均(45.5±13.9)min，术中出血量平均(52.7±11.9)ml。所有患者均获随访 12 个月以上，与术前相比，末次随访时 VAS 评分显著减少(P＜0.05)，AOFAS 评分显著增加(P＜0.05)；末次随访时足部外形恢复良好，无母外翻复发和母囊疼痛。影像方面。末次随访时母外翻角(hallux valgus angle, HVA)、第一二跖骨间角(intermetatarsal angle, IMA)、第一跖骨远端关节面角(distal metatarsal articular angle, DMAA)，以及 Handy-Clapham 胫侧籽骨分度均较术前显著减小(P＜0.05)。[结论]改良单螺钉 Scarf 截骨治疗母外翻临床疗效满意。

Abstract:

[Objective] To explore the clinical outcomes of modified single-screw Scarf osteotomy for correction of hallux valgus. [Methods] From June 2020 to February 2021, a total of 23 patients (30 feet) underwent the modified single-screw Scarf osteotomy for treatment of hallux valgus in our hospitals. The clinical and imaging data were compared between themselves preoperatively and at the last follow-up. [Results] All patients were successfully operated on without postoperative complications, and followed up for more 12 months. Compared with those preoperatively, the VAS score significantly reduced (P＜0.05), while the AOFAS score significantly increased at the latest follow up (P＜0.05). Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and Handy-Clapham tibial sesamoid scale significantly declined at the latest follow up compared with those preoperatively (P＜0.05). [Conclusion] This modified single-screw Scarf osteotomy does achieve satisfactory clinical outcomes for correction of hallux valgus.