Evans截骨跟骨外侧柱延长副舟骨切除胫后肌腱重建治疗副舟骨源性平足症的临床疗效观察  

The clinical effect observation of Evans osteotomy with reconstruction of posterior tibial tendon insertion on navicular after accessory navicular resection for treatment of the flatfoot related with accessory navicular

作　　者：颜翼 罗小中 邱志龙 陈实 戴海波 侯光辉 龙靓 徐永清[3] Yan Yi;Luo Xiaozhong;Qiu Zhilong(Department of Orthopedics,Xiangtan Central Hospital;Department of Clinical Pharmacy,Xiangtan Central Hospital,Xiangtan Hunan,411100;Orthopaedic Center of Kunming General Hospital,Chengdu Military Region,Kunming Yunan,650032,China)

机构地区：[1]湘潭市中心医院骨科,湖南湘潭411100 [2]湘潭市中心医院临床药学,湖南湘潭411100 [3]成都军区昆明总医院附属骨科医院全军骨科中心全军创伤骨科研究所,云南昆明650032

出　　处：《生物骨科材料与临床研究》2018年第4期38-41,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨Evans截骨联合胫后肌腱止点重建治疗伴前足外展副舟骨源性平足症的方法及临床疗效。方法 2013年9月~2016年9月,对20例(25足)经半年以上保守治疗疗效欠佳的伴前足外展副舟骨源性平足症患者采用Evans截骨联合胫后肌腱止点重建治疗。应用美国矫形足踝协会(AOFAS)评分标准及VAS疼痛评分评估治疗效果,同时对比术前和终末随访的足弓高度、跟骨倾斜角、前后位跟距角、侧位跟距角、前后位距骨-第1跖骨角、侧位距骨-第1跖骨角、距舟覆盖角等X片评价指标。结果术后患者切口均Ⅰ期愈合,无相关并发症发生。跟骨外侧柱延长植骨愈合。术后20例(25足)患者获随访,随访时间6~20个月,平均12个月。末次随访时中足功能AOFAS评分、VAS疼痛评分、足弓高度、跟骨倾斜角、侧位跟距角、前后位跟距角、侧位距骨-第1跖骨角、前后位距骨-第1跖骨角、距舟覆盖角等X片评价指标与术前比较,差异均有统计学意义(P<0.05)。结论采用Evans截骨联合胫后肌腱止点重建治疗伴前足外展副舟骨源性平足症可有效纠正畸形,减轻疼痛,恢复功能。Objective To study the effects for Evans osteotomy with reconstruction of posterior tibial tendon insertion on navicular for treatment of the forefoot outreach flatfoot related with accessory navicular. Methods From Sep 2013 ～ Sep2016, 20 patients（25 feet） with the forefoot outreach flatfoot related with accessory navicular were treated underwent Evans osteotomy with reconstruction of posterior tibial tendon insertion on navicular were available to follow up. We adopt AOFAS score for function evaluation and visual analogue scale（VAS） for pain evaluation. At the same time, we contrast the evaluation index in the arch height, calcaneus inclination angle, anteroposterior and lateral position talocalcaneal angle, anteroposterior and lateral position talar-first metatarsal angle, talonavicular joint angle, between pre-operation and last follow-up. Results All patients got primary wound healing without any complication except 1 patient appear little skin necrosis, and the Evans osteotomy area of bone graft was healed. Twenty patients（25 feet） were followed up 6 to 20 months with an average of 12 months. There were significant differences in the arch height, calcaneus inclination angle, anteroposterior and lateral position talocalcaneal angle, anteroposterior and lateral position talar-first metatarsal angle, talonavicular joint angle, between pre-operation and last follow-up（P〈0.05）. Conclusion The Evans osteotomy with reconstruction of posterior tibial tendon insertion on navicular for treatment of the forefoot outreach flatfoot related with accessory navicular, with correction of deformity, excellent effectiveness, and less complications.

关 键 词：平足症 副舟骨 胫后肌腱 Evans截骨 

分 类 号：R681.8[医药卫生—骨科学]