手术治疗跟距骨桥临床疗效观察  

Surgical Treatment of Talocalcaneal Coalition:A Report of 15 Cases

作　　者：崔俊成[1] 戴祝[1] 吴文特[1] 黎宇[1] 唐志斌[1] 陈志伟[1] 

机构地区：[1]南华大学附属第一医院骨科,湖南衡阳421001

出　　处：《中国现代手术学杂志》2014年第3期202-205,共4页Chinese Journal of Modern Operative Surgery

基　　金：湖南省卫生厅资助项目(C2014-10)

摘　　要：目的探讨单纯性骨桥切除术治疗跟距骨桥的临床疗效。方法回顾性分析2008年7月-2013年8月我院收治的15例跟距骨桥患者的临床资料，均行单纯性骨桥切除术。手术前后分别采用视觉模拟评分法（VAS）进行疼痛评分，美国矫形足踝协会（AOFAS）后足评分标准评价踝关节功能。结果本组15例患者均获得随访，平均时间12．3（4—24）个月。术后所有患者切口均I期愈合，无伤口或关节感染、血管神经损伤、跟距坏死等早期并发症发生。末次随访时VAS评分平均（1．7±1．2）分，明显低于术前的（8．7±0．3）分（P〈0．01）；末次随访AOFAS后足评分平均（90．1±4．3）分，显著高于术前的（40．2±2．1）分（P〈0．001）。末次随访时x线检查示无骨桥复发及关节退变发生，未见关节间隙狭窄，患者进行负重行走时无明显不适。末次随访时对患者进行满意度调查：非常满意8例，满意5例，一般2例，满意率为86．7％。结论单纯性骨桥切除术是一种治疗跟距骨桥的有效方法。Objective To assess the effect of surgical treatment for talocalcaneal coalition. Methods The clinical data of 15 cases with talocalcaneal coalition admitted from July 2008 to Aug 2013 were analyzed ret- rospectively. All cases were performed simple resection of the bone bar. The visual analogue score （VAS） and AOFAS Hindfoot scale were used to assess the patients＇overall outcome and satisfaction with the procedure. Results All 15 cases were followed up for 4 to 24 months with an average of 12.3 months. All wounds were a- chieved healing in stage I without early complication such as wound infection, joint infection, vascular or nerve injury and talocalcaneal necrosis. The VAS score of last follow-up was 1.7 ＋ 1.2, and was obviously lower than 8.7 -＋0.3 of pre-operation（P 〈0.01 ）. The AOFAS hindfoot score of last follow-up was 90.1 ＋4.3, and was re- markable higher than 40.2 _＋2.1 of pre-operation （P 〈0. 001 ）. The last X-ray showed that no talocalcaneal coali- tion recurrence, articular degeneration and joint space narrowing was observed. The degree of satisfaction revealed excellence in 8 cases, good in 5, fair in 2, and the satisfaction rate was 86.7%. Conclusion The surgery of simple resection of the bone bar is safe and effective for patients with symptomatic talocalcaneal coalition.

关 键 词：跟距联合 切除术 踝关节 关节痛 

分 类 号：R687.3[医药卫生—骨科学]