距下关节制动术在成人平足症治疗中的应用评价  

Treatment of adult flatfoot with subtalar arthroereises

作　　者：刁乃成[1] 刘凤岐[1] 杨波[1] 喻飞[1] 马立峰[1] 

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《临床和实验医学杂志》2018年第5期532-534,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的观察距下关节制动术在成人平足症中的治疗效果。方法回顾性分析首都医科大学附属北京友谊医院2015年10月至2016年10月采用距下关节制动器治疗的成人Ⅱ期平足患者24例,共33足。其中男性1例共1足,女性23例共32足,平均年龄48.70±13.27岁(21~65岁)。随访观察距下关节制动器的治疗效果,统计取出距下关节制动器的比率,并分析影响距下关节制动器取出的危险因素,评估患者对距下关节制动术的满意度。结果 24例病人均得到随访,平均随访时间19.8个月(12~26个月)。手术前后侧位距骨第一跖骨角从14.20°±1.64°改善为3.08°±1.50°(P<0.01)。手术前后距舟覆盖角从21.16°±4.56°,改善为6.91°±3.90°(P<0.01)。手术前后AOFAS踝-后足评分从54.30±6.64分改善为83.95±4.51分(P<0.01)。共有6足取出距下制动器,平均取出时间为术后10.3个月(9~12个月),总体取出率为18.18%。无论距下关节制动器大小、患者年龄、是否同时行腓肠肌松解术均对制动器的取出都没有明确影响。患者对手术(33足均单独评估)总体满意率为72.7%。结论对于成人Ⅱ期平足患者中应用距下关节制动器,可以取得较好的治疗效果,但需注意部分患者耐受性差,如有明显局部疼痛,可以将制动器取出,从而缓解不适症状。Objective To investigate the clinical efficacy of Subtalar Arthroereises for treatment of adult flexible flatfoot.Methods24patients(33feet),mean age of48.7±13.27years,who had been surgically treated for adult stage II flatfoot from October2015to October2016in Beijing Friendship Hospital,Capital Medical University were evaluated.Results Mean follow-up was19.8months.Average preoperative talar-first metatarsal angle was14.20°±1.64°and the average postoperative angle was3.08°±1.50°(P<0.01).Preoperative and postoperative talonavicular coverage angle was21.16°±4.56°and6.91°±3.90°(P<0.01),respectively.The AOFAS(American Orthopaedic Foot and Ankle Society)Ankle-Hindfoot Scale score improved from54.30±6.64to83.95±4.51(P<0.01).The overall incidence of implant removal was18.18%.Patient age and implant size and gastrocnemius recession did not have any influence on the rate of implant removal.Conclusion Arthroereisis can provide good functional outcomes for patients with stage II flexible flatfoot.

关 键 词：平足症 距下关节制动术 跗骨窦 

分 类 号：R658.3[医药卫生—外科学]