改良Keller手术联合可吸收棒治疗中重度老年性(足母)外翻的疗效分析

来源 :中国矫形外科杂志 | 被引量 : 0次 | 上传用户:w33333333
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
[目的]回顾分析改良Keller手术联合可吸收棒治疗中/重度老年性(足母)外翻的应用疗效.[方法]对中重度老年性(足母)外翻患者采用改良Keller手术以“V”型截骨方法切除第一跖骨远端、趾骨近段多余骨赘,同时术中紧缩内侧关节囊,切断内收肌,截骨端以可吸收棒交叉固定第一跖趾关节,术后辅以短腿石膏固定4周.[结果] 23例(33足),随访6~20个月,平均13个月.患足伤口除2例出现组织液化坏死,后经换药/理疗等处理痊愈,余31足皆一期愈合,1例(1足)诉偶有疼痛外,其他均无不适感,(足母)外翻角(HVA)平均改善(15.89±4.52)°;第1、2跖骨间角(IMA)平均改善(7.90±1.25)°,与术前HVA和IMA相比明显减小,差异有统计学意义(P≤0.05);美国足踝外科协会(足母)趾-跖趾-趾间关节评分由术前的(69.28±6.71)分提高到术后的(93.05±6.72)分(P≤0.05).[结论]改良Keller手术联合可吸收棒治疗中/重度(足母)外翻的疗效可靠,尤其对老年性患者适用,可避免金属物对软组织的刺激,安全有效,避免了二次手术取出内固定给老年患者带来的痛苦.“,”[Objective] To analyze the outcome of modified Keller surgery combined with absorbable stick for treatment of moderate or severe senile hallux valgus.[Methods] Twenty-three cases (33 feet) of moderate to severe senile hallux valgus were enrolled in this study and received the modified surgery.The first metatarsal distal and proximal phalanged redundant osteophytes was removed by modified Keller procedure(“V” osteotomy).Then,the medial joint capsuleis was tightened,adductor muscles was cut and the first metatarsophalangeal joint was cross-fixed with absorbable stick at the bone ends.[Results] The average follow-up time was 13 months (6 to 20 months).Two feet was found tissue liquefaction necrosis,and recovered after dressing or physiotherapy.Other 31 feet were healed at one stage.One patient complained about pain occasionally.The average improvement of hallux valgus angle (HVA) and IMA were (15.89±4.52)° and (7.90±1.25)°,respectively.The postoperative HVA and IMA significantly decreased compared with preoperation(P≤0.05).AOFAS toe-toe-toe metatarsal joint score improved from preoperative (69.28±6.71) to postoperative (93.05±6.72),with significant difference (P≤0.05).[Conclusion] The efficacy of modified Keller surgery combined with absorbable stick for treatment of moderate or severe hallux valgus is reliable,especially in elderly patients.It can avoid metal stimulation to soft tissues,thus preventing the pain from the second operation to remove internal fixation.
其他文献
期刊
为维护《中国康复》杂志的声誉和广大读者的利益,现将我刊对一稿多投和一稿多用问题的处理声明如下:1.本声明中所涉及的文稿均指原始研究的报告或尽管2篇文稿在文字的表达和讨
Objective: The use of donor-derived immature dendritic cells (imDC) has become a promising approach to induce immune tolerance or immune hyporesponsiveness. How
目的 调查福建省淡水蟹类的种类. 方法 采集福建省平潭县淡水蟹标本,进行形态学观察,调查孳生地和蟹感染并殖吸虫情况. 结果 发现一新种,定名为平潭南海溪蟹Nanhaipotamon pi
【摘要】目的观察普米克令舒联合万托林治疗毛细支气管炎的疗效。方法将确诊的52例毛细支气管炎患儿随机分为两组,两组患儿均采用抗感染、吸氧、止咳、吸痰等综合治疗。在此基础上,对照组加用氨溴索、万托林压缩雾化吸入治疗;观察组加用普米克令舒联合万托林雾化吸入治疗。结果观察组患儿显效率67.00%,总有效率92.36%;对照组患儿显效率33.7%,总有效率65.86%,差异有统计学意义(P<0.05)。结论
期刊
目的观察日本血吸虫组织蛋白酶B DNA疫苗与IL-4真核表达质粒联合免疫小鼠的效果. 方法将小鼠IL-4 基因PCR扩增片段克隆入真核表达载体pcDNA3以构建重组表达质粒.小鼠分为4组,
期刊
Due to its major role in maintaining the water-retaining properties of the epidermis,ceramide is of great commercial potential in cosmetics and pharmaceuticals
目的筛选日本血吸虫(Schistosoma japonicum, Sj)新的疫苗候选基因或雌虫性别特异性基因. 方法用Sj雌虫抗原免疫家兔制备血清,对Sj成虫cDNA文库进行免疫筛选,将阳性克隆的插
【摘 要】高血压作为临床上较为常见的心脑血管疾病,是威胁人类健康的第一杀手,合理选择抗高血压药物显得尤为重要。有效的抗高血压药物能够促进血压水平的降低,避免靶器官损害。在临床上,主要的抗高血压药物主要有ACEI类药物、β受体阻断药物、利尿药、α受体阻断药物等,这类药物在控制血压的同时,容易影响电解质、水、血糖以及血脂等代谢。因此,在降压治疗过程中,要注意抗高血压药物引起的不良反应,切实保证高血压患
期刊