| 融合治疗Ⅱ型疼痛性足副舟骨的临床分析 |
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Received:March 27, 2025
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李俊杰 |
LI Jun-jie |
浙江大学医学院附属湖州医院 湖州市中心医院骨科, 浙江 湖州 313000 |
Department of Orthopaedics, Zhejiang University School of Medicine Affiliated Huzhou Hospital Huzhou Central Hospital, Huzhou 313000 Zhejiang, China |
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| 张江枫 |
ZHANG Jiang-feng |
浙江大学医学院附属湖州医院 湖州市中心医院骨科, 浙江 湖州 313000 |
Department of Orthopaedics, Zhejiang University School of Medicine Affiliated Huzhou Hospital Huzhou Central Hospital, Huzhou 313000 Zhejiang, China |
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| 董家宝 |
DONG Jia-bao |
浙江大学医学院附属湖州医院 湖州市中心医院骨科, 浙江 湖州 313000 |
Department of Orthopaedics, Zhejiang University School of Medicine Affiliated Huzhou Hospital Huzhou Central Hospital, Huzhou 313000 Zhejiang, China |
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| 徐弥阳 |
XU Mi-yang |
浙江大学医学院附属湖州医院 湖州市中心医院骨科, 浙江 湖州 313000 |
Department of Orthopaedics, Zhejiang University School of Medicine Affiliated Huzhou Hospital Huzhou Central Hospital, Huzhou 313000 Zhejiang, China |
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| 朱根锐 |
ZHU Gen-rui |
浙江大学医学院附属湖州医院 湖州市中心医院骨科, 浙江 湖州 313000 |
Department of Orthopaedics, Zhejiang University School of Medicine Affiliated Huzhou Hospital Huzhou Central Hospital, Huzhou 313000 Zhejiang, China |
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| 李雄峰 |
LI Xiong-feng |
浙江大学医学院附属湖州医院 湖州市中心医院骨科, 浙江 湖州 313000 |
Department of Orthopaedics, Zhejiang University School of Medicine Affiliated Huzhou Hospital Huzhou Central Hospital, Huzhou 313000 Zhejiang, China |
lyfwind@126.com |
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| 期刊信息：《中国骨伤》2025年38卷，第6期，第608-612页 |
| DOI：10.12200/j.issn.1003-0034.20230994 |
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目的：探讨副舟骨融合术治疗Ⅱ型疼痛性足副舟骨的临床疗效。
方法：回顾性分析2012年1月至2022年6月采用副舟骨融合术治疗的Ⅱ型疼痛性副舟骨患者26例,其中男1例,女25例;年龄18~70(44.61±16.32)岁;ⅡA型10例,ⅡB型16例;单纯融合20例,融合加跟骨内移截骨6例。测量并比较术前和术后6个月距骨第1跖骨角(Meary角)、跟骨倾斜角(Pitch角)、距骨第1跖骨角(talar-first metatarsal angle,T1MA)、距舟覆盖角(talonavicularcoverage angle,TCA)、距跟角(lateral talocalcaneal angle,LTCA)的变化情况,并采用美国足踝外科协会(American Ortho-pedic Foot and Ankle Society,AOFAS)足踝评分和疼痛视觉模拟评分(visual analogue scale,VAS)评价其临床疗效。
结果：26例患者均获得随访,时间7~24(10.72±3.94)个月。Meary角、Pitch角、T1MA、TCA、LTCA分别由术前的(9.20±2.57)°、(16.45±3.57)°、(33.34±5.02)°、(22.42±5.86)°、(48.89±4.43)°改善至术后6个月的(3.33±1.06)°、(22.33±4.56)°、(23.89±3.48)°、(11.83±2.67)°、(36.50±3.50)°,差异均有统计学意义(P<0.01)。AOFAS足踝评分方面,术后6个月ⅡA型、ⅡB型(86.24±4.33)、(93.18±6.02)分,较术前(67.34±6.55)、(65.12±9.51)分均有明显改善,差异均有统计学意义(P<0.01);优20例,良5例,差1例。VAS方面,术前ⅡA型、ⅡB型(5.67±1.58)、(5.77±1.49)分,改善至术后6个月的(2.13±1.01)、(1.43±0.68)分,差异均有统计学意义(P<0.01)。
结论：Ⅱ型疼痛性副舟骨患者行副舟骨融合术,结合部分足跟外翻患者行跟骨内移截骨能有效矫正平足畸形,缓解疼痛,可以作为临床治疗痛性副舟骨治疗的选择。 |
| [关键词]:副舟骨 融合 力线 截骨术 |
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| Clinical analysis of fusion therapy for typeⅡpainful scaphoid of foot accessory |
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Abstract:
Objective To explore clinical effect of accessory scaphoid bone fusion in treating typeⅡpainful accessory scaphoid bone.
Methods A retrospective analysis was performed on 26 patients with typeⅡpainful accessory navicular bone treated by accessory navicular bone fusion from January 2012 to June 2022,including 1 male and 25 females,aged from 18 to 70 years old with an average of (44.61±16.32) years old;10 patients with typeⅡA and 16 patients with typeⅡB;20 patients with simple fusion and 6 patients with fusion plus calcaneal translocation osteotomy. Changes of Meary angle,Pitch angle,anteroposterior talar-first metatarsal angle (T1MA),talonavicular coverage angle (TCA),lateral talocalcaneal angle (LTCA) before operation and 6 months after operation were observed and compared,and American Orthopedic Foot and Ankle Society (AOFAS) foot and ankle score and visual analogue scale (VAS) were used to explore clinical effect.
Results All 26 patients were followed up for 7 to 24 months with an average of (10.72±3.94) months. Meary angle,Pitch angle,T1MA,TCA and LTCA were improved from (9.20±2.57) °,(16.45±3.57) °,(33.34±5.02) °,(22.42±5.86) °,(48.89±4.43) ° before opertaion to (3.33±1.06) °,(22.33±4.56) °,(23.89±3.48) °,(11.83±2.67) °,(36.50±3.50) ° at 6 months after operation,the difference were statistically significant (P<0.01). Postoperative AOFAS foot and ankle score were (86.24±4.33) and (93.18±6.02) for typeⅡA and typeⅡB at 6 months,which were significantly improved compared with those for typeⅡA and typeⅡB before operation (67.34±6.55) and(65.12±9.51),and the difference was statistically significant (P<0.01);20 patients got excellent result,5 good and 1 poor. Preoperative VAS of typeⅡA (5.67±1.58) and typeⅡB (5.77±1.49) were improved to (2.13±1.01) and (1.43±0.68) at 6 months after operation,with statistical significance(P<0.01).
Conclusion Fusion of accessory navicular bone in patients with typeⅡpainful accessory navicular bone combined with internal calcaneal osteotomy in patients with partial calcaneal valvaration could effectively correct flat foot deformity and relieve pain,and could be used as a clinical treatment for painful accessory navicular bone. |
| KEYWORDS:Accessory navicular Fusion Force line Osteotomy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李俊杰,张江枫,董家宝,徐弥阳,朱根锐,李雄峰.融合治疗Ⅱ型疼痛性足副舟骨的临床分析[J].中国骨伤,2025,38(6):608~612 |
| 英文格式: | LI Jun-jie,ZHANG Jiang-feng,DONG Jia-bao,XU Mi-yang,ZHU Gen-rui,LI Xiong-feng.Clinical analysis of fusion therapy for typeⅡpainful scaphoid of foot accessory[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(6):608~612 |
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