背景:副舟骨(AN)的手术治疗分为简单的AN切除术和用于AN切除术后重建胫骨后肌腱(PTT)的Kidner手术。然而,这两种方法都有一定的缺点。在这里,我们提出了一种改良的PTT重建方法,并将该方法与改良的Kidner手术的短期临床效果进行了比较.
方法:我们收集了2015年1月至2020年6月在我们部门接受治疗的23名患有疼痛性II型AN的青少年儿童的数据。美国骨科足踝协会踝关节后足(AOFAS-AH)成绩,MearyAngle,术前、术后记录侧重平片和俯仰角情况,评价治疗效果。
结果:在改良肾脏手术(MK)组中,AOFAS-AH中位数从61(59-68)增加到87(83-91)(P<0.05);侧重平片的俯仰角从13.0(8-18)增加到17.4(14-22),Meary角从18.3(14-24)减小到14.2(8-20)(P<0.05)。在PTT保存折叠缝合线(FS)组中,AOFAS-AH中位数从61(59-68)增加到87(85-91)(P<0.05);侧重平片的俯仰角从12.3(7-18)增加到18.4(15-26),Meary角从17.8(13-23)下降到5.7(3-8)(P<0.05)。FS组和MK组的AOFAS-AH术后评分无显著性差异;FS组侧重平片的Pitch和Meary角改善明显优于MK组(P<0.05)。
结论:对于青少年患者的II型AN疼痛,与改良的Kidner方法相比,保留插入折叠缝合术在AOFAS-AH评分方面的短期结果相似,但在Meary角度和Pitch角度方面有更大的改善.
方法:III.
BACKGROUND: The surgical treatment of accessory navicular (AN) is divided into simple resection of AN and Kidner surgery used to reconstruct posterior tibial tendon (PTT) after AN resection. However, both of these procedures have certain disadvantages. Herein, we proposed a modified method to reconstruct PTT and compared the short-term clinical effect of our method with the modified Kidner procedure.
METHODS: We collected data from 23 adolescent children with painful type II AN treated in our department between January 2015 and June 2020. The American Orthopedic Foot and Ankle Society Ankle-Hind foot (AOFAS-AH) Scores, the Meary Angle, and Pitch Angle of the lateral weight-bearing plain radiographs status were recorded before and after the operation to evaluate the treatment outcomes.
RESULTS: In the modified Kidner surgery (MK) group, the median AOFAS-AH increased from 61 (59-68) to 87 (83-91) (P < 0.05); the Pitch angle of the lateral weight-bearing plain radiographs increased from 13.0 (8-18) to 17.4 (14-22), and the Meary angle decreased from 18.3 (14-24) to 14.2 (8-20) (P < 0.05). In the PTT preservation folded suture (FS) group, the median AOFAS-AH increased from 61 (59-68) to 87 (85-91) (P < 0.05); the Pitch angle of the lateral weight-bearing plain radiographs increased from 12.3 (7-18) to 18.4 (15-26), and the Meary angle decreased from 17.8 (13-23) to 5.7 (3-8) (P < 0.05). There was no significant difference in AOFAS-AH postoperative scores between the FS group and MK group; however, the improvement on Pitch and Meary angle of the lateral weight-bearing plain radiographs was significantly better in the FS group than in MK group (P < 0.05).
CONCLUSIONS: For painful type II AN in juvenile patients, the insertion-preserving folding suture procedure had similar short-term results on AOFAS-AH scores but greater improvement in the Meary angle and the Pitch Angle than the modified Kidner method.
METHODS: III.