跟骨成形跟腱止点重建治疗Haglund综合征  

Calcaneoplasty and reattachment of Achilles tendon for Haglund's syndrome

作　　者：赖志斌 朱永展[2] 钟的桂 杨康勇 李谓林 沈国栋[2] LAI Zhi-bin;ZHU Yong-zhan;ZHONG Digui;YANG Kang-yong;LI Wei-lin;SHEN Guo-dong(The Second Clinical College of Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Foot and Ankle Surgery,Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]佛山市中医院骨八科(足踝外科),广东佛山528000

出　　处：《中国矫形外科杂志》2023年第14期1330-1333,共4页Orthopedic Journal of China

摘　　要：[目的]探讨跟骨成形跟腱止点重建术治疗Haglund综合征的临床疗效。[方法]回顾性分析本院2017年1月—2019年1月采用骨赘切除跟腱止点重建治疗Haglund综合征的26例患者。评估临床及影像学资料。[结果]所有患者均顺利完成手术,术中无血管、神经损伤等并发症,手术时间平均(58.3±17.9)min,术中出血量平均(50.8±22.6)ml,住院时间(6.8±1.1)d。所有患者均获得随访,平均随访时间(22.3±9.5)个月。随时间推移(术前,术后6、12个月及末次随访),VAS评分[(5.3±2.0),(2.5±1.2),(1.2±0.9),(1.2±0.8),P<0.05]显著减少,而AOFAS评分[(62.6±8.4),(80.6±7.6),(87.9±6.7),(89.7±5.1),P<0.05]和踝关节ROM[(33.5±9.0)°,(54.0±9.2)°,(61.3±7.7)°,(64.8±9.4)°,P<0.05]显著增加。影像方面,术后平行间距线(Parallel pitch lines,PPL)阳性率(61.5%vs 0%,P<0.05)和跟骨后角(fowler-philip angle,FPA)[(61.8±5.8)°vs(41.3±5.6)°,P<0.05]较术前显著减少。[结论]开放跟骨成形跟腱止点重建显露清楚,有利于去除Haglund综合征合并多种病变组织,临床效果满意。[Objective]To investigate the clinical outcomes of calcaneoplasty and reattachment of Achilles tendon in the treatment of Haglund syndrome.[Methods]A retrospective study was performed on 26 patients who underwent calcaneoplasty and reattachment of Achilles tendon for Haglund syndrome in our hospital from January 2017 to January 2019.The clinical and radiological documents were evaluated.[Results]All the patients had the surgical procedures performed successfully without any complications such as vascular and nerve injury,whereas with operation time of(58.3±17.9)min,intraoperative blood loss of(50.8±22.6)ml,and hospital stay of(6.8±1.1)days.All of them were followed up for(22.3±9.5)months on an average.With time elapsed preoperatively,6 and 12 months postoperatively and the latest follow-up,the VAS score significantly reduced[(5.3±2.0),(2.5±1.2),(1.2±0.9),(1.2±0.8),P<0.05],whereas the AOFAS score[(62.6±8.4),(80.6±7.6),(87.9±6.7),(89.7±5.1),P<0.05]and ankle dorsal extension-plantar flexion range of motion(ROM)[(33.5±9.0)°,(54.0±9.2)°,(61.3±7.7)°,(64.8±9.4)°,P<0.05]significantly increased.Radiographically,compared with those preoperatively,the parallel pitch lines(PPL)positive ratio(61.5%vs 0%,P<0.05)and posterior calcaneal angle(Fowler-Philip angle,FPA)[(61.8±5.8)°vs(41.3±5.6)°,P<0.05]significantly decreased postoperatively.[Conclusion]The open calcaneoplasty and reattachment of Achilles tendon have clear exposure to remove the complicated pathology involving various tissues,and achieve satisfactory clinical outcomes.

关 键 词：Haglund 综合征 跟骨成形 跟腱止点重建 

分 类 号：R687[医药卫生—骨科学]