Scarf和Chevron联合Akin截骨术对中重度拇外翻患者术后平衡的影响

Effect of Scarf and Chevron Combined with Akin on Postoperative Balance in Patients with Moderate to Severe Foot Bunion

摘要: 本研究的目的是分析Scarf和Chevron联合Akin截骨术对中度至重度拇外翻患者术后平衡的影响。方法：回顾性选取2019年01月至2023年06月在我院治疗的116例中度至重度拇外翻患者为受试者，根据手术方式分为两组。对照组接受Scarf联合Akin治疗，研究组接受Chevron联合Akin治疗。比较两组手术前后炎症因子白细胞介素-1β、降钙素(PCT)、拇外翻角(HVA)、跖骨间角(IMA)、远端跖骨关节角(DMAA)角、踝后足美国矫正足踝关节协会(AOFAS)评分、疼痛视觉模拟评分(Visual Analogue Scale, VAS)评分和平衡Berg平衡量表(Berg Balance Scale, BBS)评分。比较了两种不同手术方式的有效性和安全性。结果：研究组(5.25 ± 0.89)的IL-1β明显低于对照组(8.98 ± 1.31)，差异具有统计学意义(p < 0.05)；研究组(4.96 ± 0.67)的PCT明显低于对照组(7.69 ± 1.52)，差异具有统计学意义(p < 0.05)。研究组(15.78 ± 4.10)的HVA明显低于对照组(26.39 ± 4.75)，差异具有统计学意义(p < 0.05)；研究组(8.59 ± 2.05)的IMA明显低于对照组(13.84 ± 2.47)，差异具有统计学意义(p < 0.05)。两组间的其余指标差异无统计学意义(p > 0.05)。结论：Chevron联合Akin治疗中重度足部愈合比Scarf联合Akin更有效，后者更微创，促进术后平衡恢复效果较好。

Abstract: Objective: The purpose of this study is to analyze the effect of Scarf and Chevron plus Akin osteoto-my on postoperative balance in patients with moderate to severe hallux valgus. Methods: Retro-spectively, 116 patients with moderate to severe hallux valgus treated in our hospital from January 2019 to June 2023 were selected as subjects and divided into two groups according to the surgical procedure. The control group received Scarf with Akin and the study group received Chevron with Akin. Compared the pre-surgical inflammatory factors interleukin-1β, calcitonin (PCT), hallux val-gus angle (HVA), intermetatarsal angle (IMA), distal metatarsal joint angle (DMAA) angle, American Association for Foot and Ankle (AOFAS) score, pain visual analogue score (visual analogue scale, VAS) score, and Berg Balance Scale (Berg Balance Scale, BBS) score. The efficacy and safety of the two dif-ferent surgical procedures were compared. Results: The IL-1β in the study group (5.25 ± 0.89) was significantly lower than the control group (8.98 ± 1.31) and was statistically significant (p < 0.05); the PCT in the study group (4.96 ± 0.67) was significantly lower than the control group (7.69 ± 1.52), which was statistically significant (p < 0.05). The HVA in the study group (15.78 ± 4.10) was signifi-cantly lower than the control group (26.39 ± 4.75), and was statistically significant (p < 0.05); the IMA in the study group (8.59 ± 2.05) was significantly lower than the control group (13.84 ± 2.47), which was statistically significant (p < 0.05). No significant difference between the two groups (p > 0.05). Conclusion: Chevron Combined with Akin is more effective in treating moderate to severe foot healing than Scarf combined with Akin and Akin, which is more minimally invasive and promotes better recovery of postoperative balance.