改良内固定融合术治疗青少年足副舟骨综合征的疗效  

Clinical effect of modified internal fixation and fusion on juvenile accessory navicular syndrome

作　　者：郑伟鑫 蔡杰 任祥钰[1] 张言[2] 梁景棋 聂光华 赵宏谋[2] 梁晓军[2] ZHENG Wei-xin;CAI Jie;REN Xiang-yu;ZHANG Yan;LIANG Jing-qi;NIE Guang-hua;ZHAO Hong-mou;LIANG xiao-jun(Xi′an Medical University,Shaanxi 710068,China)

机构地区：[1]西安医学院,陕西西安710068 [2]西安交通大学附属红会医院足踝外科,陕西西安710054

出　　处：《中国临床研究》2021年第2期186-189,共4页Chinese Journal of Clinical Research

基　　金：国家自然科学基金:(81301604)。

摘　　要：目的探讨改良内固定融合术治疗青少年足副舟骨综合征(ANS)的临床疗效。方法回顾性分析西安市红会医院足踝外科自2017年3月至2019年5月收治的19例(24足)青少年ANS患者资料。所有患者均采取改良内固定融合术。测量患者术前及末次随访时负重正位X线的距舟覆盖角(TCA),负重侧位X线的跟骨倾斜角(CPA)和距骨第一跖骨角(Meary角)。采用美国足踝外科协会(AOFAS)的中足评分和疼痛视觉模拟评分(VAS)评估足部功能和疼痛改善情况。结果 19例患者术后获12~24个月随访,平均16.5个月。末次随访时,正位X线TCA与术前相比差异无统计学意义(P>0.05),侧位X线片CPA[(17.60°±2.67°)vs(15.13°±2.34°)]、Meary角[(-1.75°±-0.87°)vs(-2.60°±-1.18°)]和AOFAS中足评分(87.85±5.14 vs 57.50±3.85)、VAS评分(1.75±0.77 vs 6.00±0.51)均优于术前,差异有统计学意义(P<0.01)。所有患者未见骨不愈合、内固定失效、疼痛复发等并发症。结论对于青少年ANS患者,改良内固定融合术可以有效改善足弓,缓解症状,改善足部功能和影像学表现。Objective To explore the clinical effect of modified internal fixation and fusion in the treatment of juvenile accessory navicular syndrome(ANS).Methods The data of 19 patients(24 feet)with ANS admitted to foot and ankle surgery of Xi′an Honghui hospital from March 2017 to May 2019 were analyzed retrospectively.All patients were treated with modified internal fixation and fusion.Before and at the last follow-up,the patients were measured in terms of talocal caneal angle(TCA),calcaneal pitch angle(CPA)and talar first metatarsal angle(Meary angle).The middle foot score of the American Orthopaedic Foot and Ankle Society(AOFAS)and pain visual analogue score(VAS)were used to evaluate foot function and pain improvement.Results Nineteen patients were followed up for 12-24 months(average 16.5 months).There was no statistically significant difference in TCA between the last follow-up and before operation(P>0.05).Compared with before operation,X-ray CPA(17.60°±2.67°vs 15.13°±2.34°),Meary angle(1.75°±-0.87°vs-2.60°±-1.18°),the middle foot score of AOFAS(87.85±5.14 vs 57.50±3.85),and the VAS score(1.75±0.77 vs 6.00±0.51)were improved(P<0.01).Conclusion For juvenile ANS patients,improved internal fixation and fusion can effectively improve the arch of foot,relieve symptoms,improve foot function and imaging performance.

关 键 词：足副舟骨综合征 融合术 内固定 青少年 距舟覆盖角 跟骨倾斜角 距骨第一跖骨角 

分 类 号：R726[医药卫生—儿科]