胫后肌腱转位治疗CMT病致足下垂畸形疗效分析  

The clinical and radiographic outcomes of posterior tibial tendon transposition in the treatment of foot dropcaused by CMT disease

作　　者：温晓东 任彦宇 刘承义 李毅 Wen Xiaodong;Ren Yanyu;Liu Chengyi(Minimally Invasive and Orthopaedic Ward of Foot and Ankle Surgery Center,the Affiliated Honghui Hospital of Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安市红会医院足踝外科诊疗中心微创与矫形病区,710054

出　　处：《美中国际创伤杂志》2023年第4期1-3,13,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨胫后肌腱转位治疗CMT病足下垂畸形临床及影像学疗效。方法:回顾分析18例(30足)CMT病致足下垂畸形患者临床资料,均采用胫后肌腱转位结合其他矫形术治疗。该组病例男11例,女7例;年龄22~42岁,平均32.12岁。临床评估包括美国足踝外科协会(American orthopedic foot and ankle society,AOFAS)踝后足评分及踝关节活动度(ROM)。影像学评估包括负重足侧位片Meary角(距骨-第1跖骨角),跟骨倾斜角以及后足力线角。并记录手术相关并发症。结果:术后伤口均I期愈合。患者均获得随访,随访时间20~39个月,平均29.21个月。没有患者出现平足畸形,患者术前及末次随访影像学评估Meary角,跟骨倾斜角以及后足力线角度对比差异有统计学意义。末次随访AOFAS评分及踝关节背伸活动度较术前明显改善,差异有统计学意义。结论:胫后肌腱转位治疗CMT所致足下垂畸形可以取得满意的临床疗效,患足背伸功能改善明显。Objective:To investigate the effect of posterior tibial tendon transposition in the treatment of foot drop caused by charcot-marie-tooth(CMT)disease.Methods:The clinical data of 18 patients with foot drop after CMT disease was retrospectively analyzed.There were 1l males and 7 females with average age of 32.12 years.Functional evaluations included American orthopaedic foot and ankle society(AOFAS)scores and ankle range of motion(ROM).Radiographic evaluation for the changes of postoperative foot alignment included Meary angle,calcaneal pitch angle and hindfoot alignment angle.The operative complications were recorded.Results:All patients were followed up for 20-39 months(mean 29.21 months),the wounds healed at the first stage,no patient presented with plantar foot deformity.The comparison of Meary angle,calcaneal inclination angle and posterior foot force line angle between pre-operation and last follow-up was statistically significant.At the last follow-up,AOFAS score and ROM of ankle dorsiflexion were significantly improved compared with those before operation.Conclusion:The transposition of the posterior tibialis tendon in the treatment of foot ptosis caused by CMT can obtain satisfactory clinical results,and the function of the dorsiflexion of the affected foot can be improved obviously.

关 键 词：CHARCOT-MARIE-TOOTH病 足下垂畸形 胫后肌腱转位 

分 类 号：R68[医药卫生—骨科学]