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Jone’s术(拇长伸肌后移固定于第一跖骨头,拇趾间关节融合)是矫正拇趾垂状畸形、替代胫前肌,加强足背伸功能的常用手术方法。但对儿童、尤其是10岁以下者,趾骨骨骺尚在发育,不易做关节融合,且拇长伸肌后移后亦并发拇趾下垂。作者将手术加以改进,治疗35例拇趾垂状畸形,效果满意。 手术适应症:胫前肌肌力3级以下,踝关节其它肌群基本正常,伸拇、伸趾肌肌力正常或伴有不同程度的马蹄外翻、高弓足,拇趾垂状畸形者。 手术方法: 1.跟腱延长或加跖腱膜切断,矫正马蹄和高弓畸形。 2.拇趾近端背侧纵切口,游离拇长伸肌腱并切断。在拇趾内侧找到拇展肌,游离后切断。于拇趾第一跖骨颈处前后打一骨孔,自后向前拖出拇展肌远侧断端,顶起下陷的跖骨头,将肌腱与拇长伸肌腱近侧断端缝合固定。 3.在踝关节前方做纵切口,显露拇长伸肌及
Jone’s operation is a common surgical method to correct the sagittal deformity of the toe, to replace the anterior tibialis muscle, and to strengthen the function of the dorsalis pedis. However, children, especially those under 10, are still developing phalangeal epiphysis, not easy to do joint fusion, and after the hallux longus extensor also accompanied by hallux drooping. The authors improved the operation to treat 35 cases of sagittal deformity of the toe with satisfactory results. Surgery indications: tibialis anterior muscle strength below 3, the rest of the ankle muscles were normal, thumb, extensor muscle strength is normal or accompanied by varying degrees of horseshoe valgus, high arch, toe sagittal deformity who . Surgical methods: 1. Achilles tendon extension or plus plantar fascia cut, correction horseshoe and high bow deformity. 2. The proximal to the dorsal longitudinal incision, free thumb long extensor tendon and cut off. Find the abductor hallucis in the medial side of the big toe and cut off after it is free. Before and after the first metatarsal neck of the maxillary to play a bone hole, after dragging forward from the distal end of the abductor hallucis longus, the top of the subsidence metatarsal head, the tendon and thumb extensor tendon near the proximal stump suture fixation. 3. Longitudinal incision in front of the ankle, showing the extensor hallucis and