微创技术治疗拇外翻畸形68例疗效观察.docVIP

微创技术治疗拇外翻畸形68例疗效观察【摘要】 目的 观察微创治疗拇外翻畸形患者的治疗效果。方法 采用局麻下微创手术治疗拇外翻畸形68例,使用微型动力系统专用器械微创截骨,手法矫形、复位、绷带外固定。结果 所有患者均无并发症发生,足拇外翻畸形明显改善。随访6～36个月,手术优良率达95.59%。结论 本微创手术效果可靠,简单易行,可作为矫正拇外翻畸形的较好方法。 【关键词】 拇外翻;微创手术;疗效观察 Observation of curative effect of treatment of hallux valgus deformation with minimally invasive surgery in 68 cases LI Bao-min, ZHANG Xiao-yan, HA Si.Orthopedics department in The Third Affiliated Hospital of Inner Mongolia Medical College,InnerMongolia,Baotou014010,China 【Abstract】 ObjectiveTo study the effect of using minimally invasive operation treatment for correction of hallux valgus deformity. .Methods Sixty-eight patients suffered with hallux valgus deformation were treated with minimally invasive surgery with local anesthesia.The main technical steps include:minimal incisional osteotomy by special instrument with micro power system、orthopedic therapy、manual reduction and bandage external fixation.ResultsNo complications occurred intraoperatively or postoperatively.The hallux valgus deformities were corrected.After 6 months to 36 months follow-up.95.59 percent of patients had excellent or good results.Conclusion This minimally invasive operation is a good method for the correction of hallux valgus deformity, and shows dependable effectiveness. 【Key words】 Hallux valgus deformity; Minimally invasive operation; Observation of curative effect 作者单位:014010内蒙古医学院第三附属医院骨科 拇外翻畸形是前足最常见的病变之一,主要治疗方法为手术治疗,方法有很多种,但每种治疗方式各有利弊,其中微创技术治疗拇外翻具有切口小、痛苦小、恢复快、外观美而被广大患者选择。内蒙古医学院第三附属医院自2006年至2008年间共收治拇外翻患者68例,经采用微创技术进行治疗,均取得满意效果。现总结报告并浅淡临床体会如下。 1 临床资料 本组68例115足,男7例10足,女61例105足。年龄42 ~66岁,平均58.4岁。拇外翻角为16°~47°,平均37°。合并拇囊炎59例,第2、3跖骨头胼胝60例,第二趾骨锤状趾17例。一侧拇外翻40例,双侧拇外翻28例。 2 治疗方法 患者仰卧位, 局部浸润麻醉。用15号小圆刀在拇趾近节趾骨近端内侧做一0.3 cm横形切口直达趾骨。用小骨膜剥离器从远端向近端在拇囊和内侧跖骨头之间分离关节囊,用微型动力系统磨钻磨去内侧跖骨头处的骨赘, 持续用冲洗水将骨屑冲出,用小骨锉锉平磨骨面,不使其有棱角。在第1跖骨头颈部内侧切一约0.3 cm的横行切口直达骨膜,与前切口平行。用切割磨钻从远端向近端作一斜形截骨,倾斜约15°,截骨完毕后手法将第1跖骨头向外推移约一个骨皮质[1-2]。术毕冲洗伤口,不缝合伤口,加压包扎,并在第1~2趾蹼间加合适的分趾垫,使第1趾略内翻,用绷带绕到踝关节处行“8”字形包