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胫骨远端骨折畸形愈合后马蹄内翻畸形的手术矫正:1例报告

Surgical correction of checkrein deformity after malunited distal tibia fracture: a case report.

作者信息

Holcomb Timothy M, Temple Eric W, Barp Eric A, Smith Hayden L

机构信息

Resident, Des Moines Podiatric Residency Program, UnityPoint Health, Des Moines, IA.

Faculty, Des Moines Podiatric Residency Program, UnityPoint Health, Des Moines, IA; and Attending Physician, The Iowa Clinic, West Des Moines, IA.

出版信息

J Foot Ankle Surg. 2014 Sep-Oct;53(5):631-4. doi: 10.1053/j.jfas.2014.04.028. Epub 2014 Jun 15.

Abstract

Checkrein deformities are rare and involve entrapment or tethering of the flexor hallucis longus and, occasionally, flexor digitorum longus tendons. The deformity has typically been secondary to traumatic fractures of the talus, calcaneus, or deep posterior compartment syndrome resulting from fractures of the tibia and fibula and most fractures of the ankle. These result in flexion contractures at the interphalangeal joint of the hallux. Because of the rarity of this deformity, no single surgical technique has been defined as the standard. Previous interventions have included release of adhesions with or without Z-plasty lengthening of the involved tendons. The present study reports a case of checkrein deformity secondary to a malunited distal tibia fracture, with flexion deformities to digits 1 through 3. The patient underwent successful surgical correction with flexor tenotomies to the affected digits with interphalangeal arthrodesis to the hallux.

摘要

马蹄状畸形较为罕见,涉及拇长屈肌腱以及偶尔的趾长屈肌腱的卡压或束缚。该畸形通常继发于距骨、跟骨的创伤性骨折,或由胫腓骨骨折及大多数踝关节骨折导致的深部后室综合征。这些情况会导致拇趾指间关节出现屈曲挛缩。由于这种畸形罕见,尚无单一的手术技术被定义为标准术式。以往的干预措施包括松解粘连,同时或不同时对受累肌腱进行Z形延长术。本研究报告了一例继发于胫骨远端骨折畸形愈合的马蹄状畸形病例,累及第1至3趾出现屈曲畸形。患者通过对受累趾进行屈肌腱切断术并对拇趾进行指间关节融合术,成功接受了手术矫正。

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