- 期刊
Hallux Valgus: Soft Tissue Procedure Versus Bony Procedure
趾外翻：軟部組織術式(McBride's Procedure )與鏣骨遠端切骨術(Mitchell osteotomy)之比較
摘要
拇趾外翻是文明社會中最常見的足部問題之一，從公元 1987 年至 1992 年，共有 33 位患者，平均年齡 50 歲， 8 位男性及 25 位女性， 49 例冊趾外翻，在本院接受手術治療且平均追蹤時問為 47.8個月，其中 20 例接受 McBride , s 術式， 29 例接受鑣骨遠端切骨術（ Mitchell 05 - teotomy ）。臨床追蹤項目包括疼痛的疏解、外觀、穿鞋的舒適度及第一摭趾骨關節的活動性； 87 . 5 ％接受 McBride , s 術式的病人及 95 ％接受 Mitchell 切骨術的病人，對病情的改善感到滿意。此外，術後第一鑣趾關節角度及第一、二摭骨夾角在兩組病人開始都有明顯的改善，但接受 McBride , s 術式的病人拇跡外翻的復發率較高（ P ＜砍 05 ）。其他的併發症有：在接受 McBride , s 術式的病人有一例併發拇趾內翻；接受摭骨遠端切骨術的病人有一例癒合延遲。從本篇可看出摭骨遠端切骨術較 McBride , s 術式在冊趾外翻的治療上有較穩定的療效；況且，氮樣骨遠端切骨術有較不具破壞性、手術簡易、術後易於照顧及較好的長期臨床滿意度等優點。
關鍵字
無資料並列摘要
Hallux valgus is one of the most common fore-foot problem in civilized populations. 49 feet of 33 cases, 8 males and 25 females with an average age of 50 years old, were treated surgically from 1987 to 1992 for hallux valgus and followed up for an average of 47.8 months, comprising 20 feet with McBride’s soft tissue procedure and 29 feet of Mit hell metatarsal osteotomy. The clinical criteria for follow up included pain relief, cosmetic out look, shoe wearing comfort, metatarsophalangeal motion etc. 87.5% of the cases in the McBride’s group and 95% of the cases in the Mitchell group were satisfied with the clinical results. The immediate post-operative metatarsophalangeal (MP) angle and intermetatarsal (IM) angle were both well corrected, but there was a significantly higher recurrence rate of hallux valgus in the group with the McBride’s procedure (P ＜ 0.05). One case in the McBride’s group had the complication of hallux varus and one case from the Mitchell group had delayed union. The Mitchell bony procedure has a more stable result compared to the McBride’s soft tissue procedure for the correction of moderate hallux valgus, and the modified Mitchell osteotomy is less invasive, easier to perform, easier to care for, and has more satisfcatory long-term results.