Orthopaedic Surgery and Rehabilitation Department, Faculty of Medicine, Jagiellonian University, Zakopane 34-500, Balzera Street 15, Poland.
Foot Ankle Surg. 2008;14(2):57-61. doi: 10.1016/j.fas.2007.12.002. Epub 2008 Feb 7.
Accessory navicular bones might cause not only cosmetic problems but also be a reason of discomfort and pain. In case of inefficient conservative treatment symptomatic accessory naviculars are treated surgically.
Presentation of results of simple excision of symptomatic accessory navicular.
Material consists of 22 patients (34 feet), 17 women and 5 men, treated surgically between 1992 and 2006. Mean age at surgery was 14.1 years (9-22 years). Accessory navicular type I was present in 5 feet (14.7%), type II in 17 (50%) and type III-in 12 (35.3%). Main symptom was localized pain on the medial arch of the foot, in the height of navicular bone. Surgery consisted of simple accessory navicular excision and if needed partial resection of navicular bone. The mean follow-up period was 5.6 years (1-13 years). We analyzed: intensity of pain (VAS score system), daily and sport activity. Subjective results were analyzed using a questionnaire.
The questionnaire was returned from 21 patients: 9 patients had total pain relief, 11 considerable and one patient had persistent pain. Mean VAS results before surgery was 5.9 and 1.7 after surgery. Only one patient required analgesics occasionally. Complications were present in two patients (6.1%). All active patients returned to their sport activities.
Surgical treatment of symptomatic accessory navicular by simple excision technique gives satisfying results, surgery is minimally traumatic and risk of complications low.
副舟骨不仅会造成外观问题,还会引起不适和疼痛。对于保守治疗无效的有症状副舟骨,通常采用手术治疗。
介绍单纯切除有症状副舟骨的治疗效果。
研究对象为 1992 年至 2006 年间接受手术治疗的 22 名(34 足)患者,其中 17 名为女性,5 名为男性,平均年龄为 14.1 岁(9-22 岁)。按副舟骨分型,Ⅰ型 5 足(14.7%),Ⅱ型 17 足(50%),Ⅲ型 12 足(35.3%)。主要症状为足内侧舟骨处的局部疼痛,位于舟骨的高度。手术采用单纯切除副舟骨,如果需要,还会行部分舟骨切除。平均随访时间为 5.6 年(1-13 年)。我们分析了疼痛强度(VAS 评分系统)、日常活动和运动活动情况。通过问卷调查分析主观结果。
21 名患者返回了调查问卷:9 名患者疼痛完全缓解,11 名患者疼痛明显缓解,1 名患者仍有持续性疼痛。术前 VAS 评分为 5.9 分,术后 1.7 分。仅有 1 名患者偶尔需要服用止痛药。2 名患者(6.1%)出现并发症。所有活动患者均恢复运动。
单纯切除术治疗有症状的副舟骨可获得满意的效果,手术创伤小,并发症风险低。