摘要
目的研究TwinFix锚钉胫后肌腱重建术在疼痛性副舟骨合并平足中的治疗效果。方法将中铁阜阳中心医院2015年1月至2019年12月收治的80例疼痛性副舟骨合并平足患者作为研究对象,根据不同的手术方式将其分为锚钉组(行TwinFix锚钉胫后肌腱重建手术,n=43)与Kidner组(行改良Kidner手术,n=37),术后随访2年,比较两组患者的治疗效果、足部功能及影像学改变。结果锚钉组手术时间短于Kidner组,差异有统计学意义(P<0.05)。术后1个月,两组术后并发症发生率差异无统计学意义(P>0.05),两组切口均于一期愈合,足部正、侧位X线片显示:缝合锚钉无脱落、断裂,足弓未进一步塌陷。术后2年,两组患者患足部视觉模拟评分量表(visual analogue scale,VAS)评分均较同组术前显著降低,差异有统计学意义(P<0.05),两组间的VAS评分差异无统计学意义(P>0.05);术后2年,两组患者的美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)足部功能评分均较同组术前显著上升,差异有统计学意义(P<0.05),两组间AOFAS足部功能评分差异无统计学意义(P>0.05)。术后2年,负重侧位X线片检查提示:两组跟骨倾斜角(Pitch角)、侧位距骨第1跖骨角(Meary角)较同组术前显著上升,差异有统计学意义(P<0.05),侧位距骨-跟骨角(lateral talocalcaneal angle,LTCA)较同组治疗前显著下降,差异有统计学意义(P<0.05);负重正位X线片提示:前后位距骨第一跖骨角(anterior and posterior talar-1 first metatarsal angle,APTMT)及距舟覆盖角(talonavicular coverage angle,TCA)均较同组术前显著下降,差异有统计学意义(P<0.05);轴位X线片提示:两组跟骨外翻角均显著下降,差异有统计学意义(P<0.05),术后2年两组间的影像学相关检测指标差异无统计学意义(P>0.05)。结论TwinFix锚钉胫后肌腱重建术与改良Kidner术均能有效减轻疼痛性副舟骨合并平足患者的疼痛症状,改善足部功能,纠正平足畸形
Objective To investigate the efficacy of posterior tibial tendon reconstruction using TwinFix anchor for painful accessory navicular bone with flatfoot.Methods Eighty patients with painful accessory navicular bone and flatfoot in Fuyang Central Hospital from January 2015 to December 2019 were enrolled,and were divided into two groups according to different surgery methods,anchor group(TwinFix anchor,n=43)and Kidner group(modified Kidner technique,n=37).Patients were followed up for 2 years,and the clinical efficacy,foot function and imaging changes were compared between groups during that period.Results The operation time of anchor group was significantly shorter than that of Kidner group(P<0.05).One month after surgery,the incidence rate of postoperative complication yielded no significant difference between groups(P>0.05).Primary wound healing was achieved in all patients,and anteroposterior and lateral radiographs of the feet indicated no dislodgement or breakage of the sutured anchors and no further collapse of the arch.visual analogue scale(VAS)scores of both groups at postoperative 2 years were significantly lower than those at baseline(P<0.05),while the comparison between groups demonstrated no statistical difference(P>0.05).An increase was found in the score of American Orthopaedic Foot and Ankle Society(AOFAS)in both groups at postoperative 2 years(P<0.05),while the AOFAS scores had no statistical difference between two groups(P>0.05).After operation,weight-bearing lateral radiographs showed an increase in calcaneus inclination angle(Pitch angle)and lateral talus-first metatarsal angle(Meary angle),and a decrease in lateral talocalcaneal angle(LTA),it was with statistical differences(P<0.05).Weight-bearing anteroposterior radiographs showed a decrease in anteroposterior talus-first metatarsal angle(APTMT)and talonavicular coverage angle(TCA),it was with statistical differences(P<0.05).Axial radiographs indicated a decrease in calcaneus-valgus angle in both groups(P<0.05).The above imaging related paramet
作者
马晓辉
丁桂友
董中洋
王斌
李文涛
Ma Xiaohui;Ding Guiyou;Dong Zhongyang;Wang Bin;Li Wentao(Hand and foot microsurgery,Fuyang Central Hospital,Fuyang 236000,China)
出处
《足踝外科电子杂志》
2021年第4期51-55,共5页
Electronic Journal of Foot and Ankle Surgery
关键词
TwinFix锚钉胫后肌腱重建术
改良Kidner术
疼痛性副舟骨
平足
足部功能
posterior tibial tendon reconstruction with twinfix anchor
modified kidner technique
painful accessory navicular bone
flatfoot
foot function
