副舟骨切除联合趾长屈肌腱转位术治疗足副舟骨疼痛综合征继发ⅡA期胫后肌肌腱功能不全的临床效果

摘要

Objective To investigate the clinical efficacy of accessory navicular bone resection and flexor digitorum longus tendon transposition for stageⅡA posterior tibial tendon dysfunction ( PTTD ) secondary to symptomatic accessory navicular bone. Methods Fourteen patients(20 feet) with stageⅡA PTTD secondary to symptomatic accessory navicular bone were enrolled,and all underwent accessory navicular bone resection and flexor digitorum longus tendon transposition. The preoperative and postoperative relevant X-ray indices and American Orthopaedic Foot and Ankle Society ( AOFAS ) scores were compared. Results After operation, obvious improvement of syndromes was observed in all patients,arches of the feet were significantly recovered. The postoperative AOFAS scores were higher than the preoperative scores(P<0. 05). The postoperative first metatarsal angle of lateral talus,calcaneus inclination angle,lateral B?hler′s angle and talonavicular coverage angle were improved compared to the preoperative angles(P<0. 05). Conclusion Accessory navicular bone resection combined with flexor digitorum longus tendon transposition is an effective therapeutic approach for stageⅡA PTTD secondary to symptomatic accessory navicular bone.%目的 探讨副舟骨切除联合趾长屈肌腱转位术针治疗足副舟骨疼痛综合征继发ⅡA期胫后肌肌腱功能不全(PTTD)的临床效果.方法 选取足副舟骨疼痛综合征继发ⅡA期PTTD患者14例(20足),均行副舟骨切除+趾长屈肌腱转位术,比较术前术后相关X线指标和美国足踝外科协会(AOFAS)评分.结果 术后所有患者症状明显改善,足弓恢复明显,AOFAS评分高于术前评分(P<0.05),术后侧位第1跖骨距骨角、跟骨倾斜角、侧位跟距角、距舟覆盖角均较术前改善(P<0.05).结论 副舟骨切除联合趾长屈肌腱转位术是治疗足副舟骨疼痛综合征继发ⅡA期PTTD的有效方法.