改良Kidner手术联合肌腱镜治疗痛性副舟骨  

Outcome of modified Kidner procedure with tendoscopy for the treatment of painful accessory navicular

作　　者：罗杨 齐玮 魏民 LUO Yang;QI Wei;WEI Min(Department of Orthopaedics,General Hospital of PLA,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心骨科,北京100853

出　　处：《中国骨伤》2021年第5期448-451,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨改良Kidner手术联合肌腱镜治疗痛性副舟骨的临床疗效。方法:2014年2月至2019年4月,收治19例经6个月以上保守治疗无效的痛性副舟骨患者,男13例,女6例;年龄14~58(25.9±10.9)岁;均为单侧发病。出现疼痛至入院时间6~60个月。所有患者给予副舟骨切除联合带线锚钉重建胫后肌腱,并应用肌腱镜技术探查胫后肌腱。分别于术前及末次随访采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)的中足功能评分标准和疼痛视觉模拟评分法(visual analogue scale,VAS)进行临床疗效评价。结果:19例均获随访,时间12~73(35.0±20.9)个月。VAS术前(6.33±1.95)分,末次随访(0.20±0.41)分,差异有统计学意义(t=11.50,P<0.01);AOFAS评分术前(60.27±21.51)分,末次随访(95.53±5.79)分,差异有统计学意义(t=5.71,P<0.01)结论:改良Kidner手术联合肌腱镜技术可以有效缓解副舟骨疼痛症状,提高患足功能,疗效确切。Objective:To evaluate clinical efficacy of modified kidner procedure with tendoscopy in treating painful accessory navicular.Methods:From February 2014 to April 2019,19 patients with painful accessory navicular were admitted,including 13 males and 6 females with a mean age of 26 years old(ranged from 14 to 58 years old),all of which were unilateral symptoms.The courses of disease ranged from 6 to 60 months.All patients received excision of accessory navicular and reconstruction of posterior tibial tendon insertion on navicular with anchor,and the tendoscopy were used to examin the posterior tibial tendon.American Orthopedic Foot and Ankle Society(AOFAS)midfoot score and visual analogue scale(VAS)were used to evaluate efficacy before operation and at the latest follow-up.Results:All the patients were followed up,and the duration ranged from 12 to 73 months,with an average of(35.0±20.9)months.VAS score was 0.20±0.41 at the latest follow-up,showing significant difference when compared with preoperative score of 6.33±1.95(t=11.50,P<0.01).AOFAS score was 95.53±5.79 at the latest follow-up,showing significant difference when compared with preoperative score of 60.27±21.51(t=5.71,P<0.01).Conclusion:The modified kidner procedure with tendoscopy is a good choice for the treatment of painful accessory navicular,which could obviously relieve foot pain,improve foot function,and has certain clinical efficacy.

关 键 词：副舟骨 胫后肌腱 肌腱镜 疼痛 

分 类 号：R681.8[医药卫生—骨科学]