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踝关节前侧间隔区肌腱病

TENDINOPATHY OF THE ANTERIOR COMPARTMENT OF THE ANKLE.

作者信息

De Carvalho Junior Antonio Egydio, Bittar Cíntia Kelly, Salomão Osny, Miranda João Batista, Ninomiya André, Silva Daniel Bento

机构信息

Professor of the Department of Orthopedics and Traumatology and Head of the Foot Surgery Group, State University of Campinas (Unicamp), Campinas, SP; Attending Physician at the Institute of Orthopedics and Traumatology, Hospital das Clínicas, School of Medicine, University of Sao Paulo (USP) Sao Paulo, SP, Brazil.

Attending Physician in the Foot Surgery Group, State University of Campinas (Unicamp), Campinas, SP; Attending Physician in the Foot and Ankle Group, Orthopedics Service of the Celso Pierrô Hospital and Maternity Hospital, Catholic Pontificate University of Campinas (PUC), Campinas, SP, Brazil.

出版信息

Rev Bras Ortop. 2015 Nov 16;45(2):141-7. doi: 10.1016/S2255-4971(15)30283-4. eCollection 2010 Mar-Apr.

Abstract

OBJECTIVE

To carry out a retrospective analysis on the etiopathogenesis, diagnosis and therapeutic options in cases of tendinopathy of the anterior compartment of the ankle.

METHOD

13 patients underwent surgery between September 1998 and February 2009; ten men and three women. The right side was involved in twelve patients and the left in one. The mean age was 35 years (range 15-67). The etiology was traumatic in eight patients and degenerative (non-traumatic) in five. The mean time elapsed between diagnosis and treatment was 19 months (range 1 - 60) and the mean length of follow-up was 34 months (range 4 - 127). The diagnosis was made through anamnesis and clinical examination. Magnetic resonance imaging was performed on nine patients, for staging and planning. The surgical treatment was personalized in each case (synovectomy, resection of the muscle belly, consolidation with the adjacent tendon, and free grafting of the semitendinosus tendon). The following scales were used to evaluate the results: 1) subjective satisfaction scale, 2) AOFAS and 3) Maryland.

RESULTS

In relation to the subjective satisfaction scale, 12 patients were satisfied and one was dissatisfied. The mean AOFAS score was 80 points, and the mean Maryland scale was 86 points.

CONCLUSION

Surgical treatment is effective for restoring function. The surgical techniques need to be personalized. The option of free grafting of the semitendinosus tendon is effective for gaps larger than five centimeters.

摘要

目的

对踝关节前侧间隔区肌腱病的病因、诊断及治疗选择进行回顾性分析。

方法

1998年9月至2009年2月期间,13例患者接受了手术;其中男性10例,女性3例。右侧受累12例,左侧1例。平均年龄35岁(范围15 - 67岁)。8例患者病因是创伤性的,5例是退行性(非创伤性)的。诊断与治疗之间的平均时间间隔为19个月(范围1 - 60个月),平均随访时间为34个月(范围4 - 127个月)。通过病史采集和临床检查进行诊断。9例患者进行了磁共振成像,用于分期和治疗规划。每个病例的手术治疗都是个性化的(滑膜切除术、肌腹切除术、与相邻肌腱固定以及半腱肌腱游离移植)。使用以下量表评估结果:1)主观满意度量表,2)美国足踝外科协会(AOFAS)评分,3)马里兰评分。

结果

关于主观满意度量表,12例患者满意,1例不满意。AOFAS平均评分为80分,马里兰量表平均评分为86分。

结论

手术治疗对恢复功能有效。手术技术需要个性化。半腱肌腱游离移植对于大于5厘米的间隙有效。

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