目的探讨改良Keller手术治疗母外翻畸形的临床疗效。方法根据术前对母外翻畸形的评估,从切口的设计、近节趾骨的截骨方式和截除量、跖趾关节两侧力学平衡的矫正和术后的康复等几个方面改良Keller手术。2005年至2009年,采用此改良Keller术式治疗母趾外翻36例(62足)。所有患者均进行随访并获得相应资料,对母趾畸形的矫正程度、疼痛症状的改善及行走功能的恢复等进行充分评估。结果本组患者术后随访1~3年,疗效优46足,良11足,可3足,差2足。总优良率达92%,效果满意。结论改良的Keller手术方法治疗母外翻,尤其是重度外翻畸形患者,能有效改善足部症状,恢复行走功能,并发症较少。
Objective To investigate clinical effect of modified Keller operation on hallux valgus.Methods According to preoperative evaluation of hallux valgus deformity,traditional Keller operation was modified in some aspects such as incision design,osteotomy of proximal phalanx,the mechanical balance on both sides of metatarsophalangeal joint and rehabilitation after surgery.From 2005 to 2009,62 feet of 36 patients were treated with modified Keller operation.All patients were followed up and the degree of deformity correction,the improvement of pain and the recovery of walking function were fully evaluated.Results All cases were followed up for 1 year to 3 years and nearly 92% of the patients had good results.Conclusion Modified Keller operation is an effective method for the patients with hallux valgus especially with severe deformity and can markedly improve the symptom and function of foot,but less complications.