摘要
[目的]探讨中后足关节融合联合肌腱转位治疗平足症的临床效果。[方法]自2010年1月~2016年1月保守治疗无效的52例平足患者(52足)行手术治疗,其中男18例,女34例,年龄16~62岁,平均40.50岁。术中首先对所有患者行跖楔关节融合,再对畸形矫正不足者增加跟骨截骨和跟骰关节融合,甚至距下关节融合,最后对所有患者行胫前肌劈开转位。采用AOFAS足踝评分、VAS评分评估临床效果。[结果]术后患者切口均一期愈合,无神经损伤,感染,皮缘坏死等并发症,52例患者全部随访,随访时间12~60个月,平均35.22个月,其中49例患者术后足部外观明显改善,其余3例足部畸形改善不明显。AOFAS评分由术前的(47.51±6.23)分提高至末次随访时的(88.72±6.54)分(P<0.001),VAS疼痛评分由术前的(7.52±3.23)分降至末次随访时(2.01±1.92)分(P<0.001)。[结论]采用中后足关节融合联合肌腱移位可有效矫正平足畸形,患足功能恢复好,并发症少。
[Objective] To explore the clinical outcome of mid-posterior foot arthrodesis combined with split tendon trans- fer of tibialis anterior for treatment of flatfoot. [Methods] From January 2010 to January 2016, 52 patients with flatfoot （52 feet） refractory to theconservative treatment underwent this surgical procedure. The patients included 18 males and 34 females aged 16 to 62 years with a mean of 40.5 years. In this procedure, the metatarsocuneiformosteotomy and arthrodesis were firstly per- formed in all the patients, subsequently the calcaneus osteotomy, and calcaneocuboid, even subtalararthrodesis were added in case of insufficient deformity correction, lastly split tendon transfer of tibialis anterior was conducted in all of them. The AOFAS foot ankle score and VAS were used for evaluation of the clinical consequences. [Results] The primary incision healing achieved in all the patients without complications, such asneurovascular injury, incision infection and skin margin necrosis. All the 52 patients were followed up for 12 to 60 months with an average of 35.22 months. Of them, 47 patients had obvious improve- ment of postoperative foot appearance, whereas the remaining 3 patients did not achieve significant correction of the affected foot. The AOFAS foot ankle scores significantly improved from （47.51~6.23） preoperatively to （88.72~6.54） at the latest follow- up （P〈0.O01）, whereas the VAS considerably decreased form （7.52＋3.23） to （2.01＋1.92） （P〈0.01）. [Conclusion] The mid-pos- terior foot arthrodesis combined with split tendon transfer of tibialis anterior is effective treatment for flatfootwith advantages of efficient correction of the foot deformity, satisfactory recovery of foot function and less complication.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第3期226-229,共4页
Orthopedic Journal of China
关键词
平足症
胫前肌劈开移位
中后足关节融合
flat foot disease, split tendon transfer of tibialis anterior, mid-posterior foot arthrodesis
