影响拇趾外翻患者矫正手术效果的因素分析
Analysis of Factors Influencing the Efficacy of Corrective Surgery in Patients with Hallux Valgus
王琪 1李克锋 1黄文泽 1王欣 1郭磊1
作者信息
- 1. 云南中医药大学第三附属医院(昆明市中医医院)骨伤科(昆明,650500)
- 折叠
摘要
目的:探讨影响拇趾外翻患者矫正手术效果的因素,为临床手术治疗提供参考.方法:回顾性收集2017年11月至2022年11月收治的因拇趾外翻行矫正手术治疗的186例患者临床资料,术前、术后末次随访均采用曼彻斯特-牛津足部问卷(MOXFQ)评估手术效果,根据术后末次随访和术前MOXFQ评分的差值将患者分为改善组和无改善组.收集相关临床资料,采用多因素Logistic回归分析影响拇趾外翻患者矫正手术效果的因素.结果:术后38例患者畸形无改善,148例患者畸形改善.无改善组年龄大于改善组,差异有统计学意义(P＜0.05);女性、糖尿病、吸烟史、周围血管疾病、美国麻醉医师协会(ASA)分级＞1级、重度畸形、术后拇趾外翻复发和转移性跖骨痛比例高于改善组,差异有统计学意义(P＜0.05);微创术式比例低于改善组,差异有统计学意义(P＜0.05);术后末次随访美国足踝关节协会(AOFAS)评分及Maryland足部评分低于改善组,差异有统计学意义(P＜0.05).多因素Logistic回归分析显示术后拇趾外翻复发、转移性跖骨痛、糖尿病、术前重度畸形是拇趾外翻患者矫正手术无改善的危险因素,差异有统计学意义(P＜0.05);微创术式是保护因素,差异有统计学意义(P＜0.05).结论:术后拇趾外翻复发、转移性跖骨痛、糖尿病、术前重度畸形与拇趾外翻患者矫正手术效果较差有关,微创术式可改善手术效果.
Abstract
Objective:To explore the factors affecting the efficacy of corrective surgery in patients with hallux valgus,and to provide reference for clinical surgical treatment.Methods:186 patients who received corrective surgery for bunion valgus from November 2017 to November 2022 were retrospectively collected.The results of surgery were evaluated by Mancunian-Oxford foot questionnaire(MOXFQ)before and after the last follow-up.Patients were divided into improved group and non-improved group according to the difference of MOXFQ score between last postoperative follow-up and pre-operative.The related clinical data were collected and the factors influencing the efficacy of corrective surgery for patients with hallux valgus were analyzed by multivariate logistic regression.Results:There was no improvement in 38 patients and improvement in 148 patients.The age of the no-improvement group was higher than that of the improvement group(P＜0.05),the proportions of female,diabetes,smoking history,peripheral vascular disease,American society of aneshesiolo-gists(ASA)grade＞1,severe deformity,postoperative recurrence of bunion and metastatic metatarsal algia were higher than those of the improvement group(P＜0.05),and the proportions of minimally invasive surgery were lower than those of the improvement group(P＜0.05).The American orthopedic foot and ankle society(AOFAS)score and Maryland foot score in the last postoperative follow-up were lower than those in the improved group(P＜0.05).Multiva-riate logistic regression analysis showed that postoperative recurrence of bunion valgus,metastatic metatarsal algia,diabe-tes and preoperative severe deformity were risk factors for no improvement in bunion valgus patients(P＜0.05),and min-imally invasive surgery was protective factor(P＜0.05).Conclusion:Postoperative recurrence of bunion valgus,metastatic metatarsal algia,diabetes mellitus,and severe deformity before surgery are associated with poor surgical results in bunion valgus patients.Minimally invasive surgery can improve surgical results.
关键词
拇趾外翻/矫正手术/曼彻斯特-牛津足部问卷/复发/转移性跖骨痛/糖尿病/重度畸形/危险因素Key words
hallux valgus/corrective surgery/Manchester-Oxford foot questionnaire/relapse/metastatic metatarsal pain/diabetes/severe deformity/risk factors引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据