截骨治疗青少年拇外翻两种固定效果的比较

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1、授予单位代码10089学号或申请号13330HebeiMedicalUniversity硕士学位论文在职科学学位截骨治疗青少年拇外翻两种固定效果的比较学位申请人：张建利导师：张奉琪教授专业：外科学二级学院：第三医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河北医科大学，试验材料、原始数据

2、、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生签名：y/W,导师签章：^尸月一日目录中文摘要·············································································1英文摘要·········

3、····································································3研究论文截骨治疗青少年拇外翻两种固定效果的比较前言·············································································6材料与方法····································································6结果··············

4、·······························································8附图·············································································10附表·············································································11讨论··································

5、···········································13结论·············································································17参考文献·······································································17综述拇外翻矫形手术的并发症及其防治策略·····························20致谢·······

6、············································································28个人简历·············································································29中文摘要截骨治疗青少年拇外翻两种固定效果的比较摘要目的：通过比较青少年足拇外翻应用第1跖骨截骨矫形治疗术后，分别应用克氏针与接骨板两种方法固定截骨端的效果，找出那种固定方法效果更好。方法：回顾性研究20

7、08年1月至2014年7月期间，共收治青少年拇外翻39例（72足）,其中获得随访的患者共23例（40足），根据内固定方式不同将获得随访的患者分为A组、B组，A组用克氏针固定，B组用接骨板固定。每足术前及术后、末次随访时均拍摄足负重正侧位X线片，测量HVA和１～２IMA；根据AOFAS足拇趾、跖趾关节、趾间关节评分进行功能评估，并记录并发症发生情况。比较术前及术后、末次随访时拇外翻角（HVA）和１～２跖骨间角（IMA）及AOFAS评分评估患者功能愈后，选择SPSS19.0进行数据统计，数据采用均数±标准差（±s）来表示

8、，均数的比较采用t检验，当P<0.05时，差异具有统计学意义。结果：这两组患者中男性5例（8足），女性18例（32足）；平均年龄17.3±3.4岁（11～24岁）。平均随访15.6个月（12～20个月），无感染和不愈合发生，有2例3足（7.5％）出现负重行走时第一跖趾关节下轻度疼痛，4例7足（17.5％）出现足拇外翻复发。A组：H