改良足副舟骨切除术治疗运动员及非运动员疼痛性足副舟骨疗效分析  

Clinical Effect of Modified Surgical Treatment for Accessory Navicular Syndrome in Athletes and Non-athletes: with Analysis of 46 Cases

作　　者：梅宇[1] 郭秦炜[1] 胡跃林[1] 焦晨[1] 

机构地区：[1]北京大学第三医院运动医学研究所,北京100191

出　　处：《中国运动医学杂志》2013年第2期104-107,173,共5页Chinese Journal of Sports Medicine

摘　　要：目的：分析评价改良足副舟骨切除术治疗运动员及非运动员疼痛性足副舟骨的效果。方法：回顾2006年1月至2010年11月入院治疗的疼痛性足副舟骨患者46例（55足），男性11例，女性35例；年龄9～49岁，平均（19．8~8．6）岁；病程14天～10年，平均2年5个月；运动员2l例，非运动员25例。全部采用足副舟骨切除术并加固胫后肌腱止点。术后采用内翻位石膏固定，避免负重6周。随访时进行术后症状主观评估，并分析手术前后AOFAS中足功能评分。结果：46例（55足）副舟骨中，I型3例，II型47例，III型5例。运动员组中，17例（70．8％）存在足内翻扭伤因素，显著高于非运动员组。术后共随访43例（52足）。平均随访时间31．5个月，总体优良率93．0％，运动员组和非运动员组术后AOFAS中足功能评分均显著高于术前。结论：疼痛性足副舟骨多为II型，扭伤是引起运动员副舟骨疼痛的主要因素．切除副舟骨同时加固胫后肌腱的舟骨止点是治疗疼痛性足副舟骨的有效方法，对于运动员和非运动员同样可以取得满意的治疗效果。Objective The purpose of this study was to retrospectively analyze and evaluate the clinical effects of surgical treatment for the accessory navicular syndrome with modified excision. Methods From January 2006 to November 2010, 46 patients（55 feet） with accessory navicular syndrome received surgical treatment in our institute. There were 11 males and 35 females,including 21 athletes and 25 non-athletes. Their mean age was 19.8＋8.6 years, ranging from 9 to 49 years. The present history ranged from 14 days to 10 years. Excision of the accessory navicular bone and reinforcement of posterior tibial tendon were preformed for each case. The foot was immobilized with cast in inversion position and no weight bearing for 6 weeks. The rational symptom assessment and the AOFAS scores were used to evaluate the clinical effects before and after surgery. Results There were 3 cases of type I lesion, 47 cases of type II and 5 cases of type III. 17 of athletes （70.8%） with sprain history on feet were identified,which were significantly higher than the non-athlete group. 43 patients （52 feet） were followed-up for an average of 31.5 months, ranging from 16 months to 63 months. 93% patients revealed good and excellent recovery of foot function. The AOFAS scores in both groups were significantly improved after surgical treatment. Conclusion Type II is the most common one in painful accessory navicular syndrome, and sprain the main factor in athletic patients. Excision of accessory navicular bone and reinforcement of posterior tibial tendon is an effective method for treating painful accessory navicular syndrome.

关 键 词：足副舟骨 切除 胫后肌腱 治疗效果 

分 类 号：R87[医药卫生—运动医学] R658.3[医药卫生—临床医学]