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投稿时间：2024-05-31 网络发布日期：2025-05-20
投稿时间：2024-05-31 网络发布日期：2025-05-20
中文摘要: 目的 研究微创双弧形截骨配合中医正骨手法治疗拇外翻的临床疗效。方法 选取 2020年 8月至 2023年 8月于秦皇岛市中医医院接受治疗的 60例拇外翻患者，按照信封法随机分为对照组、观察组各 30例。对照组采用传统手术截骨治疗，观察组采用微创双弧形截骨配合中医正骨手法治疗。随访 3个月，评估两组患者的临床疗效及治疗前后的美国矫形外科足踝协会（AOFAS）踝 -后足评分，测量两组患者治疗前后的拇外翻角、第一、二跖骨间夹角及第一跖骨远端关节面角，并记录两组患者治疗前后的步速、步频、步长。结果 治疗后，观察组患者疼痛、功能、力线的 AOFAS评分高于对照组（P<0.05）；观察组患者拇外翻角、第一、二跖骨间夹角及第一跖骨远端关节面角角度小于对照组（P<0.05）；观察组患者步速、步频及步长高于对照组（P<0.05）；治疗后，观察组患者总有效率高于对照组（93.33% vs 70.00%，χ 2=5.455，P=0.020）。结论 微创双弧形截骨配合中医正骨手法可有效提高拇外翻患者的临床疗效，明显缓解临床症状，促进拇跖趾关节复位，改善患足功能及步态。
Abstract:Objective To study the clinical efficacy of minimally invasive double arc osteotomy combined with Chinese bone-setting manipulation in the treatment of hallux valgus. Methods A total of 60 hallux valgus patients who received treatment at Qinhuangdao Chinese Medicine Hospital from August 2020 to August 2023 were selected. The patients were randomly divided into a control group and an observation group, with 30 cases in each group using the envelope method. The control group received traditional osteotomy surgery, while the observation group received minimally invasive double.arc osteotomy combined with Chinese bone-setting manipulation. Follow-up was conducted for 3 months, and the clinical efficacy was assessed and the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scores were evaluated before and after treatment. The hallux valgus angle, the first and second metatarsal angles, and the first metatarsal distal joint surface angle were measured before and after treatment. The walking speed, frequency, and step length of the patients were also recorded. Results After treatment, the AOFAS scores for pain, function, and alignment in the observation group were significantly higher than those in the control group (P＜0.05) . The hallux valgus angle, first and second metatarsal angle, and first metatarsal distal joint surface angle in the observation group were significantly smaller than those in the control group (P＜0.05) . The walking speed, frequency, and step length in the observation group were higher than those in the control group (P＜0.05) . After treatment, the total effective rate was higher in the observation group than that in the control group (93.33% vs 70.00%, χ 2=5.455,P= 0.020). Conclusion Minimally invasive double arc osteotomy combined with Chinese bone-setting manipulation can effectively improve the clinical efficacy of patients with hallux valgus, significantly alleviate clinical symptoms, promote the reduction of the first metatarsophalangeal joint, and improve foot function and gait.
keywords: Chinese bone.setting manipulation Hallux valgus Distal metatarsal articular angle Intermetatarsal angle Pain Gait
文章编号： 中图分类号： 文献标志码：A
基金项目:河北省中医药管理局科研计划项目（2021386）
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引用文本：
田立，郑志永，王壮.微创双弧形截骨配合中医正骨手法治疗拇外翻[J].中国临床研究,2025,38(5):735-738,743.
田立，郑志永，王壮.微创双弧形截骨配合中医正骨手法治疗拇外翻[J].中国临床研究,2025,38(5):735-738,743.