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目的探讨联合截骨治疗青少年外翻畸形的疗效分析。方法回顾性分析2008年1月至2015年1月河北医科大学第三医院收治的联合截骨治疗青少年外翻100例(185足)患者的临床资料,其中男48例(88足),女52例(97足),年龄11~19岁,平均(15.5±3.48)岁,随访时间为18~48个月,平均(28.5±6.8)个月。手术前后均摄双足负重正侧位X线影响检查,术前测量外翻角为35°~65°,平均(49.61±14.25)°,第1、2跖骨间角15°~27°,平均(21.03±6.73)°。手术方法采用第1跖骨基底或跖骨干加第1跖骨颈截骨钢板固定或近节趾骨基底截骨克氏针固定。根据不同患者外翻的症状矫正软组织平衡,必要时松解内收肌。采用AOFAS评分评价临床疗效。结果 85例(157足)获得随访,患者外翻角为(18.18±4.55)°,第1、2跖骨间夹角为(5.07±1.70)°,平均矫正30.54°和17.33°,术后,足部评分(84.8±7.6)分,与治疗前的(46.5±9.4)分相比,差异有统计学意义(P<0.05)。结论青少年外翻以遗传为主,外翻严重。采用联合截骨位治疗青少年外翻,可矫正第1跖骨内翻同时矫正远端关节固角,提高矫正效果,降低复发率。
Objective To investigate the curative effect of combined osteotomy on cataract deformity in adolescent. Methods A retrospective analysis of 100 cases (185 feet) of adolescents with ectopic adduction admitted to the Third Hospital of Hebei Medical University from January 2008 to January 2015 was performed. Among them, 48 males (88 feet), female Fifty-two patients (97 feet) aged from 11 to 19 years (mean, 15.5 ± 3.48 years) were followed up for 18-48 months with an average of (28.5 ± 6.8) months. Preoperative and postoperative radiographs of both feet were positive lateral X-ray examination. The preoperative measurement of valgus angle was 35 ° ~ 65 ° with an average of (49.61 ± 14.25) ° and the first and second metatarsal angle was 15 ° ~ 27 °. Average (21.03 ± 6.73) °. Surgical methods using the first metatarsal base or metatarsal stem plus the first metatarsal neck osteotomy plate or proximal phalangeal osteotomy Kirschner wire fixation. Depending on the patient valgus symptoms correct soft tissue balance, if necessary, adduct muscular adduction. AOFAS score evaluation of clinical efficacy. Results A total of 85 patients (157 feet) were followed up. The maxillofacial angle was (18.18 ± 4.55) ° and the angle between the first and second metatarsals was (5.07 ± 1.70) °. The average correction was 30.54 ° and 17.33 °. Foot score (84.8 ± 7.6) points, compared with pre-treatment (46.5 ± 9.4) points, the difference was statistically significant (P <0.05). Conclusions Adolescent epilepsy is predominantly genetic, with severe eversion. The use of joint osteotomy in treatment of juvenile eversion, can correct the first metatarsal varus at the same time correct the distal joint angle, improve the correction effect and reduce the recurrence rate.