胫后肌腱转位治疗腓总神经损伤源性足下垂畸形的临床效果观察  

Clinical study of posterior tibial tendon transposition in the treatment of foot ptosis caused by common peroneal nerve injury

作　　者：张松 张永红 ZHANG Song;ZHANG Yonghong(Department of Orthopedics,Guizhou Orthopedic Hospital,Guiyang,Guizhou 550006,China)

机构地区：[1]贵州省骨科医院骨外三科,贵州贵阳550006

出　　处：《医药前沿》2021年第22期3-5,共3页Journal of Frontiers of Medicine

摘　　要：目的:观察胫后肌腱(posterior tibial tendon,PTT)转位治疗腓总神经损伤源性足下垂畸形的临床效果。方法:选取2018年6月—2020年6月于我院就诊的腓总神经损伤源性足下垂畸形患者32例,给予患者胫后肌腱转位治疗,术后6个月进行随访,比较患者术前、术后6个月跖屈活动度、背伸活动度;踝足功能(foot and ankle ability measure,FAAM)、踝后足(ankle hindfoot scale,AOFAS)评分和影像学检测指标[第一跖骨角(Meary角)、后足力线角、跟骨倾斜角]。结果:术前患者患侧跖屈活动度、背伸活动度、FAAM评分、AOFAS评分均明显低于健侧,差异显著(P<0.05),术后6个月患者跖屈活动度与健侧无显著差异(P>0.05),而患者背伸活动度、FAAM评分、AOFAS评分仍低于健侧,差异显著(P<0.05)。术后6个月与术前相比,患者Meary角、后足力线角、跟骨倾斜角差异无统计学意义(P>0.05)。结论:对腓总神经损伤源性足下垂畸形患者进行胫后肌腱转位治疗可有效改善患者踝关节活动度和足部功能,治疗后患者早期出现继发性平足畸形的可能性较低,临床治疗效果较好。Objective To investigate the posterior tibial tendon,Objective to observe the clinical effect of transposition of peroneal nerve(PTT)in the treatment of foot ptosis caused by common peroneal nerve injury.Methods from June 2018 to June 2020,32 patients with foot drop deformity caused by common peroneal nerve injury were selected and treated with posterior tibial tendon transposition.The patients were followed up 6 months after operation,and the plantar flexion activity and dorsal extension activity were compared before and 6 months after operation;Foot and ankle ability measure(FAAM),ankle hindfoot(Ankle hindfoot scale,AOFAS)score and imaging indexes(first metatarsal angle,posterior foot line angle,calcaneal inclination angle).Results The plantar flexion activity,dorsiflexion activity,FAAM score and AOFAS score of the affected side were significantly lower than those of the healthy side before operation.The plantar flexion activity of the patients was improved than that of the healthy side 6 months after operation(P>0.05),and the dorsiflexion activity,FAAM score and AOFAS score of the patients were improved(P<0.05),but still lower than that of the healthy side(P<0.05).Compared with preoperative,there was no significant difference in mean angle,posterior foot line angle and calcaneal inclination angle 6 months after operation(P>0.05).Conclusion Posterior tibial tendon transposition can effectively improve ankle range of motion and foot function in patients with foot ptosis caused by common peroneal nerve injury.The possibility of secondary flatfoot deformity is low after treatment,and the clinical treatment effect is good.

关 键 词：胫后肌腱转位治疗 腓总神经损伤 足下垂畸形 临床效果 

分 类 号：R686.1[医药卫生—骨科学]