跟骨外侧柱延长(LCL)联合胫后肌重建治疗合并疼痛性副舟骨柔韧性平足症的临床疗效
劳克诚;刘云;滕学仁;张其亮;王骥平;
摘要(Abstract)：
[目的]评估跟骨外侧柱延长(LCL)副舟骨切除胫后肌止点重建治疗疼痛性副舟骨柔韧性平足症的临床疗效。[方法]2010年1月~2014年12月,回顾性分析21例疼痛性副舟骨柔韧性平足症患者,男15例,女6例,年龄26~72岁,平均35岁。比较术前和终末随访的跟骨高度、跟骨倾斜角、距骨第一跖骨角及足踝功能评分,评估功能(AOFAS)。[结果]平均随访34.20个月(12~30个月),前足外展、后足外翻畸形获得纠正,所有患者对临床效果满意,术后6个月疼痛消失。所有病例均切口一期愈合,没有感染和神经损伤者,跟骨外侧柱延长植骨愈合。无足外侧并发症。术前和末次随访X线片各种测量参数均得到明显改善,P<0.001。AOFAS评分从术前的(49.50±4.30)分提高至末次随访(93.60±1.90)分,P<0.001。[结论]跟骨外侧柱延长(LCL)、副舟骨切除、胫后肌止点重建是治疗疼痛性副舟骨柔韧性平足症的有效的方法。
关键词(KeyWords)： 副舟骨;柔韧性平足症;跟骨截骨;外侧柱
基金项目(Foundation):
作者(Author): 劳克诚;刘云;滕学仁;张其亮;王骥平;
Email:
DOI:
参考文献(References)：
- [1]Geist ES.The accessory scaphoid bone[J].J Bone Joint Surg Am,1925,7(47):570-574.
- [2]Uglini PA,Raikin SM.The accessory navicular[J].Foot Ankle Clin,2004,9(1):165-180.
- [3]Bennett GL,Weiner DS,Leighley B.Surgical treatment of the symptomatic accessory navicular[J].J Pediatr Orthop,1990,10(10):445-449.
- [4]Prichasuk S,Sinphurmsukskul O.Kidner procedure for symptomatic accessory navicular and its relation to pesplanus[J].Foot Ankle Int,1995,16(8):500-503.
- [5]Kopp FJ,Marcus RE.Clinical outcome of surgical treatment of the symptomatic accessary navicular[J].Foot Ankle Int,2004,25(1):27-30.
- [6]Veich JM.Evaluation of the Kidner procedure in treatment of symptomatic accessary tarsalsclphoid[J].Clin Orthop,1978,131(131):210-213.
- [7]Cha SM,Shin HD,Kim KC,et al.Simple excision vs the Kidnerprocedure for type 2 accessary navicular associated with flatfoot in pediatric population[J].Foot Ankle Int,2013,34(2):167-172.
- [8]Zinsmeister B,Edelman R.A new technique for tenodesis of the tibialis posterior in the Kidner procedure[J].J Foot Surg,1985,24(6):442-444.
- [9]Chung JW,Chu IT.Outcome of fusion of a painful accessary navicular to the primary navicular[J].Foot Ankle Int,2009,30(2):106-109.
- [10]Wood WA,Spencer AM.Incidence of ostibialeexternum in clinical pesplanus[J].J Am Pediatr Assoc,1970,60(7):276-279.
- [11]Scott AT,Sabesan VJ,Saluta JR,et al.Fusion versus excision of the symptomatic type 2 accessary navicularl:a prospective study[J].Foot Ankle Int,2009,7(2):146.
- [12]Cao HH,Tang KL,Lu WZ.Medial displacement calcaneal osteotomy with posterior tibial tendon reconstruction for the flexible flatfoot with symptomatic accessary[J].The J Foot Ankle Surg,2014,53(5):539-543.
- [13]Cooper PS,Nowak MD,Shaer J.Calcaneocuboid joint pressures with lateral column lengthening(Ecans)procedure[J].Foot Ankle Int,1997,18(4):199-205.