| Objective:To compare the clinical efficacy and imaging of Chevron osteotomy and Scarf osteotomy in the treatment of hallux valgus,to understand the difference between Chevron osteotomy and Scarf osteotomy in the treatment of hallux valgus,and to choose the operation method of hallux valgus.for reference.At the same time,through the comparative study of literature,to verify the effectiveness of traditional Chinese medicine fumigating and washing in relieving the pain after hallux valgus operation.Methods:Thirty patients(35 feet)who were admitted to the orthopedics department of Jiangsu Provincial Hospital of Traditional Chinese Medicine from September 2017 to January 2019 were eligible(35 feet),including 29 women(34foot)and 1 man(1 foot).Aged 35-75 years,mean age(61.40±7.66)years;patients were randomized into 15 patients(17 feet)in the Chevron group and 15 patients(18 feet)in the Scarf group.The preoperative visual simulation VAS score and AOFAS score of the American Ankle Surgery Association were recorded.Preoperative and postoperative weight-bearing radiographs were performed for hallux valgus angle(HVA),first and second metatarsal angle(IMA),distal metatarsal articular surface angle(DMAA),first metatarsal length(ML),seeds Measurement of bone position(TSP),etc.Patients were instructed to undergo rehabilitation training after surgery;fumigation and washing with Chinese medicine were performed for 6 weeks after treatment,and the course of treatment was 4 weeks.Visual analog VAS scores were recorded at 2 weeks,6 weeks,and 10 weeks after operation,and AOFAS scores of the American Foot and Ankle Surgery Association were recorded at June and December.Statistical analysis was performed using SPSS 26.0 statistical software.Results:The HVA angles of the two groups in the 12 months after operation were not statistically different between the Chevron group(12.39 ±1.42)and the Scarf group(11.70 ±1.39)(P>0.05).Comparison of IMA angles between the two groups in the 12 months after operation was statistically different between the Chevron group(8.05±0.75)and the Scarf group(6.94 ±0.66)(P<0.01).Compared with the DMAA angle in the two groups after 12 months,there was a statistical difference between the Chevron group(7.39 ± 0.53)and the Scarf group(8.24±0.78)(P<0.01).Chevron group and Scarf group shortened the first metatarsal length by 1.66mm and 0.67mm compared with the preoperative average of 12 months after operation,which was statistically different(P<0.05).Comparison of the sesamoid position between the two groups at 12 months after operation,P>0.05,the difference was not statistically significant.Comparison of VAS scores between the two groups after surgery(3.29±0.47,4.06±0.54),6 weeks(2.24±0.44,2.89±0.47),and 10 weeks(0.47±0.51,1.33±0.59)after surgery.Chevron score All of them were relatively low,and there were statistical differences(P<0.01).Compared with the literature,the VAS scores of the two groups were significantly improved.There were no significant differences in AOFAS scores between June(74.71±6.21,73.11±5.14)and December(86.71±5.55,84.94±6.52)between the two groups(P>0.05).Conclusion:Compared with scarf osteotomy,chevron osteotomy has no significant difference in HVA,tibial sesamoid position,AOFAS score,etc.in terms of postoperative pain relief,chevron osteotomy has more advantages,and chevron osteotomy has more ability to improve DMAA,but it is more likely to cause shortening of the first metatarsal length;in ima orthopedics,scarf osteotomy has more advantages.Therefore,the clinical results of chevron osteotomy and scarf osteotomy in the treatment of hallux valgus are similar.Fumigating and washing is a simple and cheap external treatment of traditional Chinese medicine,which has obvious effect on pain relief after hallux valgus operation and is worth popularizing. |
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