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单纯副舟骨切除术治疗足副舟骨疼痛综合征
摘要点击次数: 4537   全文下载次数: 3943   投稿时间:2009-10-13    
作者Author单位UnitE-Mail
池雷霆 CHI Lei-ting 四川省骨科医院,四川 成都 610041 Sichuan Orthopaedics Hospital,Chengdu 610041,Sichuan,China yangxy520777@163.com 
李程 LI Cheng 达州市中心医院骨科  
张东 ZHANG Dong 达州市中心医院骨科  
李智 LI Zhi 达州市中心医院骨科  
黄波 HUANG Bo 达州市中心医院骨科  
张廷玖 ZHANG Ting-jiu 达州市中心医院骨科  
庾明 YU Ming 达州市中心医院骨科  
王枰稀 WANG Ping-xi 达州市中心医院骨科  
期刊信息:《中国骨伤》2009年22卷,第12期,第933-934页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:观察及评价单纯副舟骨切除术治疗足副舟骨疼痛综合征的临床疗效。

方法:从2006年11月至2008年12月,收治足副舟骨疼痛综合征患者23例25足,全部采用单纯副舟骨切除术治疗,其中男14例,女9例;年龄8~35岁,平均14.6岁;病程6个月~12年。主要症状是跑步或行走后足疼痛,多为间歇性,查体足舟骨粗隆处异常突起伴压痛,X线或CT检查发现副舟骨存在。治疗是以足副舟骨为中心做一长约2 cm弧形切口,剖开或部分切断胫后肌腱,暴露出副舟骨并切除,明显突起的舟骨隆突部分咬除和修整,胫后肌腱均予修复。术后佩戴内翻位支具2周扶双拐不负重行走,2周后逐渐弃拐负重,3个月内避免剧烈跑跳运动。有残留症状者结合理疗和足弓垫支撑垫等处理措施。术后随访评估患者症状缓解程度及活动恢复情况。

结果:所有病例术后随访3~18个月,平均12个月。症状完全消失21足,大部分缓解4足(其中3足合并轻度扁平足,1足合并陈旧扭伤).平均住院5 d,无切口感染,均恢复日常生活和工作。

结论:单纯副舟骨切除术治疗足副舟骨疼痛综合征,对胫后肌腱损伤小,不干扰足底内侧纵弓,术后无须长时间制动,住院时间短,创伤小,临床疗效较好,特别适合无扁平足及陈旧足外伤患者。
[关键词]:  疼痛  外科手术
 
Surgical treatment of the accessory navicular syndrome with simple excision
Abstract:

Objective: To observe and evaluate the clinical effects of surgical treatment for the accessory navicular syndrome with simple excision.

Methods: From November 2006 to December 2008,23 patients(twenty-five feet)with accessory navicular syndrome received simple excision of the accessory navicular bone. The chief complains were intermittent pain of feet after running or walking. Physical examination showed local tenderness on palpation in the region of the navicular bone. X-ray or CT showed there was an accessory navicular bone. The present history ranged from 6 months to 12 years. There were 14 males and 9 females. The mean age was 14.6 years,ranging from 8 to 35 years. About 2 cm long incision was made at the tip of the medial prominence of the navicular bone. After partial dissection of the posterior tibial tendon,the accesssory navicular bone was exposed and excisied. The prominence of the tuberosity of the navicular bone was cut and shaved. the posterior tibial tenden was repaired before closing the wound. The foot was immobilized with cast or brace in inversion position and no weight-bearing for 2 weeks. Strenuous jumping or dancing must be avoided in 3 months after surgery. The patients with residual symptoms and signs received physical therapy and an arch support for shoes without flatfoot deformity.

Results: The average clinical follow-up during was 12 month(ranged,3 to 18 months). The excellent results in 21 feet and good in 4 feet(3 feet with mild flat deformity and 1 foot with old sprain injury). The average hospital stay was 5 days and no wound infection occurred. All patients resumed the normal life and study after operation.

Conclusion: Surgical treatment of the accessory navicular syndrome with simple excision has the advantages of less invasive to the posterior tibial tenden and the medial longitudinal arch of the foot,shorter time of immobilization of the foot and stay in hospital,small incision and good clinical results. This procedure is one of the best selective treatments for the accessory navicular syndrome,especially for the patients without flatfoot deformity and old sprain injury.
KEYWORDS:Foot  Pain  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:池雷霆,李程,张东,李智,黄波,张廷玖,庾明,王枰稀.单纯副舟骨切除术治疗足副舟骨疼痛综合征[J].中国骨伤,2009,22(12):933~934
英文格式:CHI Lei-ting,LI Cheng,ZHANG Dong,LI Zhi,HUANG Bo,ZHANG Ting-jiu,YU Ming,WANG Ping-xi.Surgical treatment of the accessory navicular syndrome with simple excision[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(12):933~934
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