Zadek截骨术治疗Haglund综合征的临床疗效  

Clinical Effect of Zadek Osteotomy on Haglund Syndrome

作　　者：郑伟鑫 张言[1] 梁景棋 赵宏谋[1] 杨杰[1] 王欣文 梁晓军[1] 王军虎[1] Zheng Weixin;Zhang Yan;Liang Jingqi;Zhao Hongmou;Yang Jie;Wang Xinwen;Liang Xiaojun;Wang Junhu(Department of Foot and Ankle Surgery,Honghui Hospital,Xi’an Jiao Tong University,Xi’an 710054,China)

机构地区：[1]西安交通大学附属红会医院足踝外科,陕西西安710054

出　　处：《实用骨科杂志》2023年第1期19-21,37,共4页Journal of Practical Orthopaedics

摘　　要：目的 探讨Zadek截骨术(Zadek osteotomy, ZO)治疗Haglund综合征(Haglund syndrome, HS)的临床疗效。方法 回顾性研究2018年3月至2020年7月在西安交通大学附属红会医院足踝外科因HS行ZO治疗并最终获得随访的17例患者。男11例,女6例;年龄23~58岁,平均(39.7±10.2)岁;左足14例,右足3例。术前及末次随访时采用美国足踝外科协会(American orthopaedic foot and ankle society, AOFAS)踝-后足评分和疼痛视觉模拟评分(visual analogue scale, VAS)评估足部功能和疼痛改善情况。测量患足术前、术后的踝关节活动度(range of motion, ROM)和患足负重侧位X线片的Chauveaux-Liet(CL)角。结果 术后患者切口均Ⅰ期愈合,无深部感染或骨髓炎发生。17例患者均获随访,随访时间12~24个月,平均(19.3±1.2)个月。末次随访时AOFAS评分由术前(51.2±5.1)分提升至(88.4±4.5)分;VAS由术前(6.4±2.3)分改善为(0.9±1.0)分;踝关节背伸ROM由术前(23.4±2.4)°提升至(29.3±1.2)°;跖屈ROM由术前(32.4±3.4)°提升为(33.1±3.5)°;CL角由术前(18.1±1.2)°改善为(9.3±2.0)°。结论 ZO截骨术治疗HS患者可以显著改善患者的疼痛症状和踝关节功能,减缓HS的进展,是一项安全、有效的技术。Objective To investigate the clinical effect of Zadek osteotomy(ZO) in the treatment of Haglund syndrome(HS).Methods A retrospective study was conducted on 17 patients who underwent ZO treatment for HS in the Department of Foot and Ankle Surgery of the Honghui Hospital affiliated to Xi’an Jiaotong University from March 2018 to July 2020 and were finally followed up.11 males and 6 females were included.The age ranged from 23 to 58 years, with an average of(39.7±10.2) years.There were 14 left feet and 3 right feet.The American orthopaedic foot and ankle surgery(AOFAS) ankle-posterior foot score and visual analog scale(VAS) were used to evaluate the improvement of foot function and pain before and at the last follow-up.Measure the range of motion(ROM) of the ankle joint before and after the operation of the affected foot and the Chauveaux-Liet(CL) angle of the lateral X-ray film of the affected foot.Results No deep infection or osteomyelitis occurred.17 patients were followed up for 12 to 24 months, with an average of(19.3±1.2) months.At the last follow-up, the AOFAS score increased from(51.2±5.1) to(88.4±4.5),the VAS score improved from(6.4±2.3) to(0.9±1.0),the ankle dorsiflexion activity increased from(23.4±2.4)° to(29.3±1.2)°,the plantar flexion activity changed from(32.4±3.4)° to(33.1±3.5)°,and the CL angle changed from(18.1±1.2)° to(9.3±2.0)°.Conclusion Using ZO to treat HS patients can significantly improve the pain symptoms and ankle function, and slow down the progress of Achilles tendon disease, which is a safe and effective technology.

关 键 词：Zadek截骨术 Haglund综合征 踝关节活动度 

分 类 号：R682.16[医药卫生—骨科学]