撕脱骨块摘除缝合桥技术重建跟腱止点治疗BeavisⅢ型跟骨结节撕脱骨折的效果  

Effect of reconstruction of Achilles insertion with Suture bridge technology after extirpation of avulsed bones block in the treatment of Beavis typeⅢavulsion fracture of the calcaneal tuberosity

作　　者：闫荣亮[1] 曹立海[1] 彭义[2] 宋子豪 杨越 刘洪达[2] 王良[1] 任原 Yan Rongliang;Cao Lihai;Peng Yi;Song Zihao;Yang Yue;Liu Hongda;Wang Liang;Ren Yuan(Department 1 of Foot and Ankle Surgery,Tangshan Second Hospital,Tangshan 063000,China;Department 2 of Foot and Ankle Surgery,Tangshan Second Hospital,Tangshan 063000,China;Department of Orthopedics,Tangshan Workers'Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市第二医院足踝外一科,唐山063000 [2]河北省唐山市第二医院足踝外二科,唐山063000 [3]河北省唐山市工人医院骨一科,唐山063000

出　　处：《中国综合临床》2025年第1期26-31,共6页Clinical Medicine of China

基　　金：河北省医学科学研究课题计划(20191518)。

摘　　要：目的观察撕脱骨块摘除缝合桥技术重建跟腱止点治疗BeavisⅢ型跟骨结节撕脱骨折的效果。方法采用回顾性研究,以2013年1月至2023年1月唐山市第二医院足踝外一科、足踝外二科手术治疗的BeavisⅢ型跟骨结节撕脱骨折患者为研究对象,根据治疗方式不同,选择其中采取撕脱骨块摘除缝合桥技术重建跟腱止点治疗的41例患者为观察组;采取跟骨结节撕脱骨折切开复位内固定治疗的37例患者为对照组。比较两组患者的切口迟延愈合率、术后1年Haglund畸形发生率、Maryland足功能评定优良率、美国足踝骨科协会(American Orthopedic Foot and ankle Society,AOFAS)踝-后足评分、疼痛评分、跟腱评分及按Arner-Lindholm疗效评定标准评价优良率。正态或近似正态分布的计量资料组间比较采用独立样本t检验,计数资料组间比较采用χ^(2)检验。结果术后1年,观察组患者发生Haglund畸形发生率为4.88%(2/41),低于对照组的29.73%(11/37),两组比较差异有统计学意义(χ^(2)=8.65,P=0.003);观察组患者的Maryland足功能评定优良率为85.37%(35/41)高于对照组56.76%(21/37),两组比较差异有统计学意义(χ^(2)=7.86,P=0.005);观察组AOFAS踝-后足评分[(90.44±6.66)分]高于对照组[(82.84±7.43)分],两组比较差异有统计学意义(t=4.77,P<0.001);观察组疼痛评分[(1.51±1.05)分]低于对照组[(2.95±1.13)分],两组比较差异有统计学意义(t=-5.81,P<0.001);观察组跟腱评分[(81.05±5.87)分]高于对照组[(71.62±8.60)分],两组比较差异有统计学意义(t=5.70,P<0.001);观察组患者的跟腱Arner-Lindholm疗效评价优良率87.80%(36/41)高于对照组67.57%(25/37),组间比较差异有统计学意(χ^(2)=4.67,P=0.031)。结论采取撕脱骨块摘除的方式治疗BeavisⅢ型跟骨结节撕脱骨折可在摘除撕脱骨块的同时截除增生的骨赘、硬化骨质及跟骨Haglund畸形,清理变性的跟腱、止点周围炎性组织;采取缝合桥技术重建跟腱�ObjectiveTo observe the effect of reconstruction of Achilles insertion with Suture bridge technology after extirpation of avulsed bones block in the treatment of Beavis typeⅢavulsion fracture of the calcaneal tuberosity.MethodsThe retrospective analysis was used.From January 2013 to January 2023,78 patients with Beavis typeⅢavulsion fracture of the calcaneal tuberosity,treated in the Department 1 of Foot and Ankle and Department 2 of Foot and Ankle of the second Hospital of Tangshan were selected as research objects.According to different operation performed,41 patients with the reconstruction of Achilles insertion with Suture bridge technology after extirpation of avulsed bones block were divided into the observation group and 37 patients with the open reduction internal fixation(ORIF)were divided into the control group.The delayed wound healing rate and the Haglund malformation rate,Maryland foot score,the American Orthopedic Foot and ankle Society(AOFAS)ankle-hindfoot score,the pain Visual Analogue Scale/Score(VAS)score,the Victorian Institute of Sports Assessment-Achilles(VISA-A)score,Arner-Lindholm scale of One-year postoperative were compared between these two groups.The measurement data with normal or approximate normal distribution were analyzed using t test,count data using chi-square test for comparison of between groups.ResultsOne year after surgery,the incidence of Haglund malformation in the observation group was 4.88%(2/41),which was lower than the control group's 29.73%(11/37).The difference between the two groups was statistically significant(χ^(2)=8.65,P=0.003).The excellent and good rate of Maryland foot function assessment in the observation group was 85.37%(35/41)higher than that in the control group(56.76%(21/37),and the difference between the two groups was statistically significant(χ^(2)=7.86,P=0.005).The AOFAS ankle hind foot score of the observation group((90.44±6.66)points)was higher than that of the control group((82.84±7.43)points),and the difference between the two groups was

关 键 词：跟腱断裂 跟骨结节 撕脱骨折 缝合桥技术 

分 类 号：R68[医药卫生—骨科学]