采用中央肌腱劈开入路对插入性钙化性跟腱病进行手术治疗。
Surgical management of insertional calcific achilles tendinosis with a central tendon splitting approach.
作者信息
Johnson Keith W, Zalavras Charalampos, Thordarson David B
机构信息
Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA.
出版信息
Foot Ankle Int. 2006 Apr;27(4):245-50. doi: 10.1177/107110070602700404.
BACKGROUND
Insertional calcific Achilles tendinosis is a painful, frequently disabling condition. Numerous operative approaches for this problem have been described. This study evaluated the outcome of a central tendon splitting approach.
METHODS
Twenty-two patients were evaluated after a central tendon splitting approach for persistent insertional calcific Achilles tendinosis. Followup averaged 34 (11 to 64) months. Suture anchors were routinely used to augment the tendon insertion after debridement. An American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, shoewear comfort, and return to work were evaluated. A paired t-test was used to evaluate the results.
RESULTS
Pain significantly improved from 7 points preoperatively to 33 points postoperatively (p < 0.001). Function improved significantly from 36 points to 46 points (p < 0.001). The ankle-hindfoot score improved from 53 points to 89 points (p < 0.001). Age older or younger than 50 years did not affect outcome.
CONCLUSION
A central tendon splitting approach yielded good relief of pain with improved function, shoewear, and ability to work without painful postoperative scars.
背景
插入性跟腱钙化性肌腱病是一种疼痛且常导致功能障碍的疾病。针对此问题已有多种手术方法被描述。本研究评估了中央腱劈开术的疗效。
方法
对22例采用中央腱劈开术治疗持续性插入性跟腱钙化性肌腱病的患者进行评估。随访平均时间为34（11至64）个月。清创后常规使用缝线锚钉加强肌腱附着点。评估美国矫形足踝协会（AOFAS）后足评分、鞋类舒适度及重返工作情况。采用配对t检验评估结果。
结果
疼痛评分从术前的7分显著改善至术后的33分（p < 0.001）。功能评分从36分显著提高至46分（p < 0.001）。踝后足评分从53分提高至89分（p < 0.001）。年龄大于或小于50岁不影响疗效。
结论
中央腱劈开术能有效缓解疼痛，改善功能、鞋类舒适度及工作能力，且术后无疼痛性瘢痕。
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