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目的:探讨在老年中重度踇外翻手术中应用改良Akin截骨治疗踇外翻预防踇僵硬的临床疗效。方法:2018年6月至2019年9月，对40例中重度踇外翻合老年患者分别行跖骨截骨联合Akin截骨术(传统Akin截骨组)和跖骨截骨联合改良Akin截骨术(改良Akin截骨组)，比较两组术前、后踇外翻角(HVA)、第1、2跖骨间角(IMA)、美国足踝外科协会(AOFAS)第一跖趾关节评分标准、踇趾背伸活动度。结果:随访时间平均4.2个月，其中32足(80.0%)基本无痛，8足偶有疼痛(20.0%)，1例(2.5%)踇外翻复发，患者对畸形矫正满意。传统Akin截骨组HVA由术前(29.51±4.41°)纠正为(9.52±2.43°)、IMA由术前(17.39±2.48°)纠正为(8.18±2.05°)、第一跖趾关节评分由术前(51.42±4.91)纠正为(77.53±3.20)、踇趾背伸活动度由术前(36.10±3.59°)至术后(27.90±3.80°)；改良Akin截骨组HVA由术前(31.18±5.31°)纠正为(9.39±3.00°)、IMA由术前(18.41±2.38°)纠正为(8.15±2.00°)、第一跖趾关节评分由术前(51.95±4.36)纠正为(83.00±3.13)、踇趾背伸活动度由术前(34.26±3.04°)至术后(36.20±4.05°)，术前两组患者HVA角、IMA角、第一跖趾关节评分、术前踇趾背伸活动度及术后HVA角、IMA角差异无统计学意义(均n P>0.05)，术后第一跖趾关节评分、踇趾背伸活动度差异有统计学意义(n t＝5.46、5.91，n P<0.05)。n 结论:应用改良Akin截骨预防踇外翻术后踇僵硬的临床效果明显，适宜推广。“,”Objective:To investigate the clinical effect of modified Akin osteotomy on the prevention of post-surgery hallux rigidus in elderly patients with moderate to severe hallux valgus.Methods:From June 2018 to September 2019, 40 elderly patients with moderate to severe hallux valgus received metatarsal osteotomy combined with Akin osteotomy or metatarsal osteotomy combined with modified Akin osteotomy.The hallux valgus angle(HVA), 1-2 intermetatarsal angle(IMA), range of motion of the first metatarsophalangeal joint according to the scoring criteria of American Orthopaedic Foot and Ankle Society(AOFAS), and hallux extensibility before and after surgery were recorded and analyzed.Results:Patients were followed up for an average of 4.2 months.Of the 40 patients, 32(80.0%)had largely pain-free feet, 8(20.0%)had feet with occasional pain and 1(2.5%)had hallux valgus recurrence.Patients were satisfied with the correction of the deformity.For the Akin osteotomy group, the HVA was corrected from 29.51±4.41° to 9.52±2.43°, IMA from 17.39±2.48° to 8.18±2.05°, the first metatarsophalangeal joint score from 51.42±4.91 to 77.53±3.20, and the range of motion of the hallux toe extension from 36.10±3.59° to 27.90±3.80°.For the modified Akin osteotomy group, the HVA was corrected from 31.18±5.31°to 9.39±3.00°, IMA from 18.41±2.38° to 8.15±2.00°, the first metatarsophalangeal joint score from 51.95±4.36 to 83.00±3.13, and the range of motion of the hallux toe extension from 34.26±3.04° to 36.20±4.05°.There were no statistically significant differences between the two groups in preoperative HVA, IMA, first metatarsophalangeal joint score, or the range of motion of the hallux toe extension or in postoperative HVA or IMA, but there were statistically significant differences in the postoperative first metatarsophalangeal joint score and the range of motion of the hallux toe extension between the two groups(n t=5.46 and 5.91, n P<0.05).n Conclusions:Modified Akin osteotomy has clear clinical efficacy on the prevention of post-surgery hallux rigidus for hallux valgus, is easy to implement, and should be recommended.