Integrative Medicine And Promote The Use Of Minimally Invasive Evaluation Of The Efficacy Of The Treatment Of Hallux Valgus

Background:Hallux vaglus is one of the common malformation in the foot, it influences the normal life and work seriously. It can be divided into conservative treatment and operative treatment at present. Since conservative treatment could not get the satisfying curative effect, most of the patients need operative treatment to correct the malformation. But there are lots of operation methods. Traditional operation methods adopt large incisions. In spite of correcting the malformations, they bring about the problems of slow recovery rate, serious pains that could not be ignored. With the development of minimally invasive in use of foot surgery, it is possible to cure hallux vaglus using minimally invasive techniques. Chinese and western medicine combined with minimally invasive technique, on behalf of minimally invasive surgery in foot, has the advantages of simple operation, less postoperative pain, no inner fixation, early Shimoji, fast recovery rate, less cost, is fit to be expanded.Objective:To verify the curative effect of Chinese and western medicine combined with minimally invasive technique in the treatment of hallux valgus among basic-level hospitals, and to determine the feasibility and stability of this technique in basic-level hospitals.Method:1Training methodAll the operators in every center and the participants in the project should be trained by senior doctor Wen Jianmin in Wangjing hospital.2Clinical research methodsWhen all the operators in every center can operate the technique intimately, adopting the method of comparing itself before and after the treatment in multicenter, we applies Chinese and western combined with minimally invasive surgery to the standard50feet,10feet in every center. The span of revisiting ranges from10to16weeks, on average of12.5weeks. Then we check HVA、IMA、 tenderness index、the motion of first plantar toe、VAS、AOFAS before and after the treatment, and horizontally compare the curative effect among every center at the same time, analyze the data by SPSS17.0at last.3Quality controllingIncluding controlling the operation of technique, postoperative treatment effect, the measurements of observational index, AOFAS, nature information, expulsion cases, the appointment of inspector and data management, every center is well controlled in terms of surgery operating, anesthesia, bandage-fixing, postoperative rehabilitation, the Case Report Form writing, patients revisiting, cases writing, index typing in, observational index locking and handling. So we can make sure the clinical experiment can be carried out in the way of Clinical implementation, and all the cases, index be right written completely in line with original data.Results:The baseline of patients subordinated in the five centers is in the same level. After the treatment of Chinese and western medicine combined with minimally invasive technique, HAV, IMA and the other observational index have obvious changes compared to those before the treatment. It proves that Chinese and western medicine combined with minimally invasive technique has outstanding curative effect in redressing malformation of hallux valgus. All the patients subordinated are checked after1course of treatment, HVA are respectively25°-38°and11°-16°before and after the treatment. Comparing the index before and after the treatment HVA drops18.04°on average, IMA drops1.6°on average. HVA decrease from31.42°±3.03°to13.38°±1.19°,and IMA decreases from12.50°±1.02°to10.90°±1.20°on average. The AOFAS score increases from29.90±3.70to91.60±6.96, rising61.70on average. The VAS score decreases from8.06±0.74to0.42±0.50, dropping7.640on average. Tenderness decreases from2.38±0.49to0.46±0.50. The motion of first plantar toe are respectively67.60°±4.41°and65.44°±4.20°before and after the treatment, dropping2.16°on average. At the same time, comparing the index of the patients among the five centers, the number changed of HVA, IMA, VAS, AOFAS, tenderness has no obvious differences.Conclusion:Chinese and western medicine combined with minimally invasive technique can obviously redress the malformation of hallux valgus. In the applications to center of Miyun hospital of traditional Chinese medicine, Xinghe bone fracture hospital, Shahe hospital, Fengsheng bone fracture hospital, verifying by clinical, the technique is effective.reliable and easy to be applied.