踇外翻SCARF截骨矫正术对患侧膝骨性关节炎进展的影响
Effect of SCARF Osteotomy Operation of Hallux Valgus on the Stage of Knee Osteoarthritis Patients in the Lesion Side
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摘要: 目的 探究踇外翻SCARF或反向SCARF截骨矫正术后对患者膝关节骨性关节炎疾病进展的影响.方法 采用回顾性分析将2012年3月至2014年3月在云南省中医医院骨科住院诊断为中、重度踇外翻并伴有患侧膝关节骨性关节炎资料完整的45例患者纳入研究.将22例SCARF或反向SCARF截骨患者纳入手术组, 而将23例保守治疗患者纳入非手术组.对治疗前后2组间患者踇外翻足部畸形常规角度测量比较采用t检验.对住院治疗前后2组间患者同侧膝关节骨性关节炎分期采用χ2检验进行分析.结果 23 a后随访: (1) 与非手术组患者相比手术组患者踇外翻足部畸形各项常规角度测量值明显改善, 差异有显著统计学意义 (P<0.01) ; (2) 与非手术组患者相比手术组患者患侧膝关节骨性关节炎进展速度明显降低, 治疗前后分期关联明显, 有显著统计学意义 (P<0.01) ; (3) 与手术组患者相比非手术组患者患侧膝关节骨性关节炎进展速度明显加快, 治疗前后分期无关联, 无统计学意义 (P>0.05) ; (4) 经χ2检验治疗后2组患者膝骨性关节炎分期构成比明显不同, 有显著统计学意义 (P<0.01) .结论 对伴有患侧踇外翻的膝关节骨性关节炎患者来说应当积极采用SCARF (或反向SCARF) 截骨术治疗踇外翻, 不仅可以治疗踇外翻的局部症状, 而且可以减慢患侧膝关节骨性关节炎的病理进展速度.
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关键词:
- 踇外翻 /
- 膝关节骨性关节炎 /
- SCARF或反向SCARF截骨手术
Abstract: Objective To investigate the effect of SCARF or reverse SCARF osteotomy operation of Hallux Valgus on the stage of knee osteoarthritis patients in the lesion side.Methods Retrospective analysis was used to recruit the 45 patients who were diagnosed as moderate or severe Hallux Valgus accompanying Knee osteoarthritis on the lesion side and had complete data.We divided the 22 cases who received the SCARF (or reverse SCARF) osteotomy operation into operation group and divided the 23 cases who received the no-operation treatments into no-operation group.T test was used to compare the difference of Hallux Valgus common malformation angles between of two groups before and after the resident treatment.χ2 test was used to compare the difference between two groups on stages of knee osteoarthritis before and after the resident treatment.Results Follow-up for 2-3 yearsr: (1) Compared with the no-operation group, the amelioration of Hallux Valgus common malformation angles measured of operation patient group, the difference had statistical significance (P <0.01) . (2) Compared with the no-operation group the accelerating speed of knee osteoarthritis in the lesion side of operation patient group was delayed, the relation of staging before and after the treatment had significant difference (P <0.01) . (3) Compared with the operation group, the accelerating speed of knee osteoarthritis in the lesion side of operation patient group was increased without the relation of staging before and after the treatment and had no significant difference (P>0.05) . (4) After the treatment, the constitution rate difference of Knee Osteoarthritis between the two groups had statistical significance (P<0.01) .Conclusion For the patients who suffered from Hallux Valgus and Knee Osteoarthritis in the lesion side, active applying the SCARF or reverse SCARF osteotomy operation of Hallux Valgus may not only cure the local symptoms of Hallux Valgus but also delay the pathological accelerating speed of Knee Osteoarthritis in the lesion side. -
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