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超声辅助跟骨成形术

Ultrasound-assisted calcaneoplasty.

作者信息

Madarevic Tomislav, Rakovac Ivan, Ruzic Lana, Tudor Anton, Gudac Madarevic Davorka, Prpic Tomislav, Sestan Branko

机构信息

University Hospital for Orthopaedic Surgery Lovran, Marsala Tita 1, 51415, Lovran, Croatia,

出版信息

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2250-3. doi: 10.1007/s00167-013-2692-8. Epub 2013 Sep 26.

Abstract

PURPOSE

The endoscopic technique for resection of a postero-superior part of calcaneus served as a golden standard during the last 10 years, and it has mostly replaced the open techniques. In an effort to reduce the morbidity and the recovery time, we had introduced the ultrasound-assisted technique.

METHODS

In the period of 1 year, 15 patients with the prominent postero-superior part of calcaneus and retrocalcaneal bursitis were operated through the single skin incision using the ultrasound-assisted technique. The prominent part of calcaneus was resected with a bone abrader under the ultrasound control to the point when there was no impingement between Achilles tendon and calcaneus in maximal dorsal flexion. The patients were evaluated preoperatively and postoperatively with the AOFAS score and Ogilvie-Harris score. The strength test of the muscle triceps surae, as well as the proprioceptive test, was also undertaken.

RESULTS

Initially, the follow-up was meant to last 6 months, but there were no differences in results between 6 weeks and 3 months postoperatively, so it was concluded that the 3-month follow-up is sufficient and relevant. All 15 patients were available for follow-up. All measured variables significantly improved (AOFAS, Ogilvie-Harris), and all the patients were satisfied with the postoperative result. Only one minor complication occurred: superficial infection.

CONCLUSION

The ultrasound-assisted calcaneoplasty enables a precise resection of the postero-superior part of calcaneus and removal of the retrocalcaneal impingement. This method could become clinically relevant as it enables effective treatment of Haglund deformity, and results of this study presented rapid functional recovery.

LEVEL OF EVIDENCE

Case series with no comparison group, Level IV.

摘要

目的

在过去10年中,内镜下切除跟骨后上部的技术一直是金标准,并且它已基本取代了开放手术技术。为了降低发病率和缩短恢复时间,我们引入了超声辅助技术。

方法

在1年的时间里,15例跟骨后上部突出并伴有跟腱后滑囊炎的患者通过单一皮肤切口采用超声辅助技术进行手术。在超声引导下,使用骨磨头切除跟骨突出部分,直至在最大背屈时跟腱与跟骨之间无撞击。术前和术后采用美国足踝外科协会(AOFAS)评分和奥吉尔维-哈里斯(Ogilvie-Harris)评分对患者进行评估。还进行了小腿三头肌力量测试以及本体感觉测试。

结果

最初,随访计划持续6个月,但术后6周和3个月的结果并无差异,因此得出结论,3个月的随访就足够且具有相关性。所有15例患者均接受了随访。所有测量变量(AOFAS、Ogilvie-Harris)均有显著改善,所有患者对术后结果均满意。仅发生了1例轻微并发症:浅表感染。

结论

超声辅助跟骨成形术能够精确切除跟骨后上部并消除跟腱后撞击。该方法可能具有临床应用价值,因为它能够有效治疗Haglund畸形,并且本研究结果显示功能恢复迅速。

证据水平

无对照组的病例系列,IV级。

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