三排无结锚钉固定技术治疗止点性跟腱炎的疗效分析  

Curative effect of triple row unknotted anchoring technique in the treatment of insertional Achilles tendinitis

作　　者：解冰 韩天宇 田竞 Xie Bing;Han Tianyu;Tian Jing(Department of Orthopedics,General Hospital of Northern Theater Command,Shenyang Liaoning,110016,China)

机构地区：[1]中国人民解放军北部战区总医院骨科,辽宁沈阳110016

出　　处：《生物骨科材料与临床研究》2025年第1期37-40,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的评价三排无结锚钉固定技术治疗成人止点性跟腱炎(insertional Achilles tendinitis,IAT)的临床疗效。方法回顾分析2015年1月至2021年1月中国人民解放军北部战区总医院采用三排无结锚钉固定技术治疗的16例(16足)症状性成人IAT患者的临床资料。其中男15例,女1例,平均年龄27.4岁(20~38岁)。手术均选择后正中入路将跟腱止点于跟骨结节处剥离,行病损组织切除,采用三排无结锚钉固定技术行腱骨止点固定。记录术后并发症、复发及跟腱断裂、穿鞋舒适度、恢复单足提踵及正常运动情况,并采用疼痛视觉模拟评分(visual analogue scale,VAS)和美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分评价临床疗效。结果16例患者均获术后随访,平均随访时间为22.3个月(12~48个月)。术后出现1例切口裂开、1例切口浅表感染,无血管、神经及肌腱损伤发生,随访期间无跟腱断裂发生。末次随访时,13例患者(81.3%)可以到达无痛单足提踵,15例(93.8%)正常穿鞋足跟无顶压痛,14例(87.5%)可以恢复正常运动水平。末次随访时VAS评分及AOFAS评分均较术前明显改善,差异有统计学意义(P<0.05)。结论对于成人IAT患者,三排无结锚钉固定技术可以有效缓解疼痛、改善患足功能,临床疗效满意。Objective To evaluate the curative effect of triple row unknotted anchoring technique in the treatment of insertional Achilles tendinitis(IAT).Methods Clinical data of 16 patients(16 feet)with symptomatic IAT treated with triple row unknotted anchoring technique from January 2015 to January 2021 at General Hospital of Northern Theater Command were respectively analysed.There were 15 males and 1 female,with a mean age of 27.4 years(range,20-38 years).The posterior median approach was selected to strip the Achilles tendon insertion at the calcaneal tubercle,and then the lesion tissues were removed.The tendon-bone insertion was fixed by triple row unknotted anchoring technique.Wound complications,recurrence and rupture of the Achilles tendon,ability to perform the single heel rise test,return to normal footwear and activities of daily living were regularly recorded after operation.Clinical efficacy was evaluated according to the visual analogue scale(VAS)and the American Orthopedic Foot and Ankle Society(AOFAS)Ankle and Hindfoot Scale.Results All 16 cases were followed up for a mean of 22.3 months(range,12-48 months).There was 1 case of incision dehiscense and 1 case of superficial incision infection.No Achilles tendon rupture occurred during follow-up.At the last follow-up,13 cases(81.3%)were able to perform the single heel raise test without pain,15 cases(93.8%)were able to wear regular shoes without tenderness,and 14 cases(87.5%)were able to return to normal activity levels.At the last follow-up,both the VAS score and AOFAS scores showed significant improvement compared to the preoperative scores,and the difference was statistically significant(P<0.05).Conclusion In adult patients with IAT,the triple row unknotted anchoring technique can effectively relieve pain and improve function of the affected foot with satisfactory clinical effect.

关 键 词：跟腱炎 后正中入路 锚钉 

分 类 号：R686[医药卫生—骨科学]