【摘要】：[目的]回顧分析改良Keller手術(shù)聯(lián)合可吸收棒治療中/重度老年性鐷母外翻的應(yīng)用療效。[方法]對(duì)中重度老年性鐷母外翻患者采用改良Keller手術(shù)以"V"型截骨方法切除第一跖骨遠(yuǎn)端、趾骨近段多余骨贅,同時(shí)術(shù)中緊縮內(nèi)側(cè)關(guān)節(jié)囊,切斷內(nèi)收肌,截骨端以可吸收棒交叉固定第一跖趾關(guān)節(jié),術(shù)后輔以短腿石膏固定4周。[結(jié)果]23例(33足),隨訪6~20個(gè)月,平均13個(gè)月�；甲銈诔�2例出現(xiàn)組織液化壞死,后經(jīng)換藥/理療等處理痊愈,余31足皆一期愈合,1例(1足)訴偶有疼痛外,其他均無(wú)不適感,鐷母外翻角(HVA)平均改善(15.89±4.52)°;第1、2跖骨間角(IMA)平均改善(7.90±1.25)°,與術(shù)前HVA和IMA相比明顯減小,差異有統(tǒng)計(jì)學(xué)意義(P≤0.05);美國(guó)足踝外科協(xié)會(huì)鐷母趾-跖趾-趾間關(guān)節(jié)評(píng)分由術(shù)前的(69.28±6.71)分提高到術(shù)后的(93.05±6.72)分(P≤0.05)。[結(jié)論]改良Keller手術(shù)聯(lián)合可吸收棒治療中/重度鐷母外翻的療效可靠,尤其對(duì)老年性患者適用,可避免金屬物對(duì)軟組織的刺激,安全有效,避免了二次手術(shù)取出內(nèi)固定給老年患者帶來(lái)的痛苦。
[Abstract]:Objective: to retrospectively analyze the effect of modified Keller operation combined with absorbable rod in the treatment of moderate / severe senile valgus. [methods] A modified Keller procedure was used to remove the distal first metatarsal bone and redundant proximal phalangeal osteophyte in patients with moderate and severe senile valgus. Meanwhile, the medial articular capsule was constricted and adductor muscle was cut off during the operation. The first metatarsophalangeal joint was cross-fixed with absorbable rod at the end of osteotomy and was fixed with short leg plaster for 4 weeks. [results] 23 cases (33 feet) were followed up for 6 ~ 20 months (mean 13 months). Except for 2 cases of tissue liquefaction and necrosis, which were cured by dressing change / physiotherapy, 31 feet were healed in one case (1 foot) with occasional pain, and no discomfort was found in all the other cases. The mean improvement of (HVA) and (IMA) were (15.89 鹵4.52) 擄and (7.90 鹵1.25) 擄, respectively. Compared with those before operation, HVA and IMA decreased significantly. There was a significant difference (P 鈮，

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