改良Zadek截骨治疗跟骨Haglund综合征  

Modified Zadek osteotomy for the treatment of Haglund syndrome

作　　者：张浩 李兴华[2] 王爱国[2] 白玉[2] 朱梁豫[2] 张宇飞 张高伟 ZHANG Hao;LI Xin-hua;WANG Ai-guo;BAI Yu;ZHU Liang-yu;ZHANG Yu-fei;ZHANG Gao-wei(College of Bone Injury,Henan University of Traditional Chinese Medicine,Zhengzhou 450008,China;Zhengzhou Orthopaedic Hospital,Zhengzhou 450052,China;Henan University of Traditional Chinese Medicine,Zheng-zhou450002,China)

机构地区：[1]河南中医药大学骨伤学院,河南郑州450008 [2]河南省郑州市骨科医院,河南郑州450052 [3]河南中医药大学,河南郑州450002

出　　处：《中国矫形外科杂志》2023年第13期1220-1223,共4页Orthopedic Journal of China

摘　　要：[目的]介绍改良Zadek背侧闭合楔形跟骨截骨术治疗Haglund综合征的手术技术和初步临床效果。[方法]2019年5月—2021年8月应用改良背侧闭合楔形跟骨截骨术治疗Haglund综合征12例。患者取健侧卧位,行跟腱前外侧纵行切口,暴露跟腱止点以清除病变滑囊组织,并根据术前设计进行跟骨后上结节截骨及跟骨体楔形截骨。截骨后闭合楔形截骨区域,使跟腱止点向前上方旋转位移,矫正畸形。[结果]12例患者均顺利完成手术,无严重并发症。随访时间9~24个月。与术前相比,末次随访时,VAS评分,AOFAS踝-后足部评分及影像测量跟骨FPA角度均显著改善(P<0.05),根据Arner-Lindholm评分,优10例,良2例,优良率为100%(12/12)。[结论]采用改良术式治疗Haglund综合征,可有效缓解足跟疼痛,矫正跟骨结节后突畸形以及恢复踝关节功能。[Objective]To introduce the surgical technique and preliminary clinical effect of modified Zadek dorsal closed wedge calca⁃neus osteotomy for Haglund syndrome.[Methods]From May 2019 to August 2021,12 patients received modified dorsal closed wedge calca⁃neal osteotomy for Haglund syndrome.The patient was placed in the healthy side lateral position,a longitudinal incision on the anterolateral side of the Achilles tendon was made to expose the insertion of the Achilles tendon.After debridement of pathology bursa,osteotomies were conducted beginning from posterior superior calcaneal tubercle and wedging into the calcaneal body according to the preoperative design.Subsequently,the wedge-shaped bone block was removed,the wedge was closed by rotating and displacing the Achilles tendon insertion bone fragment forward and upward to correct the deformity.[Results]All the 12 patients had operation completed successfully without seri⁃ous complications,and followed up for 9~24 months.Compared with those before operation,the VAS score,AOFAS ankle and hindfoot score and Fowler-Philip angle measured on images were significantly improved at the last follow-up(P<0.05).According to Arner Lindholm crite⁃ria,10 cases were excellent,2 cases were good,with the excellent and good rate of 100%(12/12).[Conclusion]This modified Zadek dorsal closed wedge calcaneus osteotomy for Haglund syndrome does effectively relieve heel pain,correct calcaneal tubercle retrogression deformi⁃ty to restore ankle function.

关 键 词：Haglund综合征 跟骨截骨术 止点性跟腱炎 足跟痛 

分 类 号：R681.8[医药卫生—骨科学]