改良腓骨沟加深支持带重建治疗腓骨肌腱滑脱症  

Modified peroneal sulcus deepening combined with reconstruction of superior peroneal retinaculum for treatment of peroneal tendon subluxation

作　　者：邓明明 杜瑞[1] 付炳金[1] 赵永杰 孙广超[1] DENG Ming-ming;DU Rui;FU Bing-jin;ZHAO Yong-jie;SUN Guang-chao(Department of Foot and Ankle Surgery,The Affiliated Hospital,Binzhou Medical College,Binzhou,256603,China)

机构地区：[1]滨州医学院附属医院足踝外科,山东滨州256603

出　　处：《中国矫形外科杂志》2021年第9期794-798,共5页Orthopedic Journal of China

摘　　要：[目的]探讨改良腓骨沟加深支持带重建治疗腓骨肌腱滑脱症的手术疗效。[方法]回顾性分析2013年7月~2019年6月,手术治疗的腓骨肌腱滑脱症患者43例。依据术前医患沟通,22例接受改良腓骨沟加深支持带重建术,21例接受常规腓骨沟加深支持带重建术。比较两组手术时间、术中失血量、住院时间、围手术期并发症、VAS评分、AOFAS评分、踝背伸-跖屈活动度(range of motion,ROM)。[结果]两组手术时间、术中失血量、住院时间、围手术期并发症差异无统计学意义(P>0.05)。两组患者随访12~24个月,平均(13.21±3.89)个月。随时间推移,两组VAS评分显著减少(P<0.05),而AOFAS评分和ROM均显著增加(P<0.05)。术前两组间VAS和AOFAS评分,以及ROM的差异均无统计学意义(P>0.05);术后3个月时改良组的VAS和AOFAS评分,以及ROM均显著优于常规组(P<0.05);末次随访时,两组在VAS评分和ROM的差异无统计学意义(P>0.05),但是改良组AOFAS评分仍显著优于常规组[(94.36±2.34)vs(89.90±2.12),P<0.05]。[结论]与常规腓骨沟加深支持带重建术相比,改良腓骨沟加深支持带重建术不增加手术时间、出血量、住院天数及围手术期并发症,且效果更佳,快速康复。[Objective]To explore the clinical outcomes of modified peroneal sulcus deepening combined with reconstruction of superior peroneal retinaculum for treatment of peroneal tendon subluxation.[Methods]A retrospective study was conducted on 43 patients who received surgical treatment for peroneal tendon subluxation from July 2013 to June 2019.According to preoperative doctor-patient communication,22 patients received modified peroneal sulcus deepening combined with superior peroneal retinaculum reconstruction,while the other 21 patients received conventional counterpart surgical procedures.The patients in the two groups were compared regarding to the operation time,intraoperative blood loss,hospital stay,perioperative complications,VAS score,AOFAS score,and ankle dorsiflexion-plantar flexion range of motion(ROM).[Results]There were no statistically significant differences in operation time,intraoperative blood loss,hospital stay,and perioperative complications between the two groups(P>0.05).The patients in both groups were followed up for 12~24 months,with an average of(13.21±3.89)months.The VAS scores decreased significantly(P<0.05),while the AOFAS scores and ROM increased significantly in both groups over time(P<0.05).Although there were no statistically significant differences in VAS and AOFAS scores and ROM between the two groups before surgery(P>0.05),the modified group proved significantly superior to the conventional group in VAS and AOFAS scores and ROM at 3 months postoperatively(P<0.05).At the latest follow-up,the differences between the two groups in VAS score and ROM became not statistically significant(P>0.05),but the AOFAS score of the modified group was still significantly better than that of the conventional group[(94.36±2.34)vs(89.90±2.12),P<0.05].[Conclusion]Compared with the conventional procedures,the modified peroneal sulcus deepening combined with superior peroneal retinaculum reconstruction does not increase the operation time,blood loss,hospitalization days and perioperative complications,i

关 键 词：腓骨肌腱滑脱 腓骨沟加深 腓骨上支持带 手术治疗 

分 类 号：R687[医药卫生—骨科学]