跗骨间骨桥临床诊断与治疗研究进展  

PROGRESS IN DIAGNOSIS AND TREATMENT OF TARSAL COALITION

作　　者：李春光[1] 俞光荣[1] 

机构地区：[1]同济大学附属同济医院骨科,上海200065

出　　处：《中国修复重建外科杂志》2012年第7期874-879,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(81071471)~~

摘　　要：目的总结跗骨间骨桥临床诊断与治疗研究进展。方法查阅近年关于跗骨间骨桥的诊断及治疗相关文献,进行综述分析。结果跗骨间骨桥是足部跗骨间桥接组织,常见类型为跟距骨桥和跟舟骨桥。跟舟骨桥在后足斜位X线片即可确诊,多数跟距骨桥需CT扫描确诊,MRI可用于软骨性和纤维组织性骨桥的诊断。石膏固定对于有症状患者是首选治疗方法;对于治疗失败未发生退行性变患者,切除骨桥可取得良好治疗效果。单纯距下关节融合可用于治疗跟距骨桥切除失败的患者,对于距下关节融合失败和跟舟骨桥切除失败的患者可行三关节融合术。微创治疗应严格掌控手术适应证。结论跗骨间骨桥诊断方法较为明确,应将临床表现和影像学检查结合以提高诊出率。手术治疗指征尚存在争议,仍需基于随机对照试验的长期随访报道。Objective To review the progress in the diagnosis and treatment of tarsal coalition. Methods Recent literature concerning the diagnosis and treatment of tarsal coalition was reviewed. Results Tarsal coalition is a bridge between the tarsal bones of the foot. The most common types are talocalcaneal and calcaneonavicular coalitions. Calcaneonavicular coalitions can be diagnosed with an oblique radiograph of the hindfoot. Most talocalcaneal coalitions require computer tomography for diagnostic confirmation. Magnetic resonance imaging may be useful for diagnoses of cartilaginous and fibrous coalition. Casting is the usual initial treatment for the symptomatic individual. For patients with treatment failure and no degenerative changes, resection of the coalition can be performed with good results. Isolated subtalar fusion may be performed for patients with failure of talocalcaneal resections. For patients undergoing failure of subtalar fusions and calcaneonavicular resection, triple arthrodesis may be performed. During minimally invasive operation, operation indications should be strictly controlled. Conclusion The diagnosis method of tarsal coalition is clear. The clinical manifestation combined with imaging examination can improve the diagnosis rate. The surgical indication of tarsal coalition remains controversial, the randomized prospective studies are still required.

关 键 词：跗骨间骨桥 诊断 治疗 研究进展 

分 类 号：R687.3[医药卫生—骨科学]