全后足关节镜下跟距骨桥切除治疗青少年疼痛性跟距骨桥的疗效分析  

Endoscopic resection of symptomatic talocalcaneal coalition in adolescents using a posterior approach

作　　者：郝云甲[1] 王爱国[1] 范家强[1] 吕泽祥 张艳 Hao Yunjia;Wang Aiguo;Fan Jiaqiang;Lv Zexiang;Zhang Yan(Department of Orthopaedics,Xuzhou Central Hospital,Xuzhou 221009 China;Departmentof Pediatrics,Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院骨科,徐州221009 [2]徐州市中心医院儿科,徐州221009

出　　处：《中华创伤骨科杂志》2022年第11期1003-1007,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨全后足关节镜下跟距骨桥切除治疗青少年疼痛性跟距骨桥的疗效。方法回顾性分析2017年2月至2020年12月徐州市中心医院骨科采用全后足关节镜技术治疗的15例(16足)青少年疼痛性跟距骨桥患者资料。男11例,女4例;平均年龄14.3岁(11~17岁);单纯左侧9例,单纯右侧5例,双侧1例;10例患者既往有踝关节扭伤史。术后采用疼痛视觉模拟评分(VAS)、美国足踝外科协会(AOFAS)踝-后足评分、健康状况调查简表(SF-36)评分评定手术效果,同时记录并发症发生情况。结果15例患者术后获平均19.9个月(12~36个月)随访。末次随访时患者VAS评分由术前的6(6,7)分降低至1(1,3)分,AOFAS踝-后足评分由术前的(54.1±10.4)分提高至(90.0±16.6)分,SF-36评分由术前的(55.5±12.7)分提高至(88.7±6.5)分,以上项目术前与末次随访时比较差异均有统计学意义(P<0.05)。随访期间无一例患者发生切口感染、骨桥复发、关节退变等并发症。结论对于青少年疼痛性跟距骨桥,全后足关节镜下跟距骨桥切除治疗具有创伤小、恢复快、并发症少、切除精准等优点,是一种有效的治疗方法。Objective To evaluate the outcomes of endoscopic resection of symptomatic talocalcaneal coalitions inadolescents usingaposteriorapproach.Methods Aretrospectivecase-series studywas performed to analyze the data of 15 adolescent patients(16 feet)with symptomatic talocalcaneal coalitions(TCC)who had been treated by posterior arthroscopy from February 2017 to December 2020 at Department of Orthopaedics,Xuzhou Central Hospital.There were 11 boys and 4 girls with an average of 14.3 years(from 11 to 17 years).The left side was affected in 9 and the right side in 5 patients,and both sides were involved in one.Ten patients had a history of ankle sprain.The clinical outcomes were evaluated by visual analogue scale(VAS),American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot score and 36-item short form health survey(SF-36)postoperatively.ResultsThe 15 patients were followed up for a mean time of 19.9months(from 12 to 36 months).At the final follow-up,the VAS significantly decreased from preoperative 6(6,7)points to 1(1,3)point,the AOFAS ankle-hindfoot score significantly increased from preoperative(54.1±10.4)points to(90.0±16.6)points,and the SF-36 score significantly improved from preoperative(55.5±12.7)points to(88.7±6.5)points(P<0.05).Follow-ups found such complications as infection,TCC recurrence or osteoarthritis in noneof the patients.Conclusion Endoscopic TCC resection using a posterior approach is an effective surgery for symptomatic TCC in adolescents,showing advantages of limited invasion,fast recovery,a low rateof postoperativecomplications andprecise resection.

关 键 词：青少年 关节镜检查 踝关节 跟距骨桥 切除 后方入路 

分 类 号：R726.8[医药卫生—儿科]