可吸收螺钉在踇外翻第1跖骨远端改良chevron截骨中的应用**☆

背景：第1跖骨远端改良chevron截骨是治疗踇外翻的常用术式，应用可吸收螺钉进行固定的效果尚存争议。 目的：评价可吸收钉在踇外翻第1跖骨远端改良chevron截骨中的应用效果。 方法：对8例中度踇外翻患者行远端改良chevron截骨，V形截骨后采用1枚2.7 mm可吸收螺钉固定，穿前足免负重鞋6~8周。 结果与结论：纳入的8例患者均获随访，随访时间28~46个月。患者伤口均一期愈合，踇外翻角改善为15°~21°，平均(17.63±2.07)°；第1，2跖骨间角为7°~9°，平均(8.00±0.76)°；美国足踝外科协会踇趾-跖趾-趾间关节评分由术前的(70.13±7.10)分提高到术后的(92.75±7.30)分(P < 0.05)。说明远端改良chevron截骨后使用可吸收螺钉固定治疗轻中度踇外翻疗效可靠，是一种有效的固定方法。 关键词：可吸收螺钉；踇外翻；chevron截骨；踇趾；跖趾；趾间关节 doi:10.3969/j.issn.1673-8225.2012.12.024

Application of biodegradable screws in the treatment of hallux valgus deformity with distal chevron osteotomy

BACKGROUND: Distal chevron osteotomy is a common treatment for hallux valgus. But there is still controversial about the clinical outcome of biodegradable screws. OBJECTIVE: To evaluate the effect of biodegradable screws fixation for distal chevron osteotomy in the treatment of hallux valgus. METHODS: Eight patients (eight feet) with moderate hallux valgus deformity were treated by modified chevron osteotomy, and then, one 2.7 mm biodegradable screw was used for internal fixation. After operation, patients were asked to walk in a wooden-soled shoe for 6-8 weeks. RESULTS AND CONCLUSION: All patients were followed up for 28-46 months. There was no nonunion, delayed union or infection. The hallux valgus angle was improved 15°-21°, with a mean of (17.63±2.07)°. The intermetatarsal angle was improved 7°-9° with a mean of (8.00±0.76)°. The scores of Hallux Metatarsophalangeal-Interphalangeal Scale issued by the American Orthopaedic Foot Ankle Society were significantly increased from (70.13±7.10) points before operation to (92.75±7.30) points after operation (P < 0.05). It is indicated that biodegradable screw fixation for chevron osteotomy in the treatment of hallux valgus deformity is effective and reliable.