运动员与普通人群中的副舟骨综合征
Accessory Navicular Syndrome in Athlete vs General Population.
作者信息
Jegal Hyuk, Park Young Uk, Kim Jin Su, Choo Ho Sik, Seo Young Uk, Lee Kyung Tai
机构信息
Foot and Ankle Service, KT Lee's Orthopedic Hospital, Seoul, Korea.
Department of Orthopedic Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea
出版信息
Foot Ankle Int. 2016 Aug;37(8):862-7. doi: 10.1177/1071100716644791. Epub 2016 Apr 18.
BACKGROUND
Symptomatic accessory navicular syndrome (ANS) typically develops in young athletes. The symptoms are exacerbated during exercise or while walking, affecting the sports performance of athletes. The purpose of this study was to evaluate the radiologic findings and clinical course in athletes with accessory navicular syndrome (ANS) in comparison with a nonathletic population.
METHODS
Seventy-nine patients with ANS between August 2012 and August 2013 were included. Overall, 29 were athletes and 50 were not athletes, and 19 (2 athletes and 17 nonathletes) of them improved after at least 6 months of conservative treatment. The records of 60 patients (64 consecutive feet) of ANS treated by modified Kidner operation were evaluated retrospectively. The study population included 27 athletes (31 feet) and 33 nonathletes (33 feet). Clinical features and radiologic findings were compared between them.
RESULTS
Overall, 34% of the nonathletes improved after conservative treatment, but only 6.9% of athletes improved (P < .001). Mean age at surgery in the athlete group was 16.1 years (range, 12-26), and 24.3 years (range, 12-52) in the nonathlete group (P < .001). There was a history of trauma in 23 feet (74%) of the athlete group and in 13 feet (39%) of the nonathlete group (P = .006). Eighteen feet (58%) in the athlete group and 11 feet (32%) in the nonathlete group showed movement between the 2 bones (P = .047). Bone marrow edema was observed in both navicular and accessory navicular in all of the athletes (27/27, 100%). But it was only present in 80% (16/20) for nonathletes (P = .012).
CONCLUSION
The radiologic findings and clinical course of athletes were different from that of the general population. Their symptoms were more refractory to conservative treatment than the nonathletes group. Therefore, early operative treatment could be considered in cases of symptomatic ANS especially for athletes.
LEVEL OF EVIDENCE
Level III, retrospective comparative case series.
背景
有症状的副舟骨综合征（ANS）通常在年轻运动员中出现。症状在运动或行走时会加重，影响运动员的运动表现。本研究的目的是比较运动员与非运动员群体中副舟骨综合征（ANS）的影像学表现和临床病程。
方法
纳入2012年8月至2013年8月期间的79例ANS患者。总体而言，29例为运动员，50例为非运动员，其中19例（2例运动员和17例非运动员）在至少6个月的保守治疗后病情有所改善。对60例行改良Kidner手术治疗的ANS患者（64只足）的记录进行回顾性评估。研究人群包括27例运动员（31只足）和33例非运动员（33只足）。比较他们的临床特征和影像学表现。
结果
总体而言，34%的非运动员在保守治疗后病情改善，但只有6.9%的运动员病情改善（P <.001）。运动员组手术时的平均年龄为16.1岁（范围12 - 26岁），非运动员组为24.3岁（范围12 - 52岁）（P <.001）。运动员组23只足（74%）有外伤史，非运动员组13只足（39%）有外伤史（P =.006）。运动员组18只足（58%）和非运动员组11只足（32%）在两块骨头之间出现活动（P =.047）。所有运动员（27/27，100%）的舟骨和副舟骨均观察到骨髓水肿。但非运动员中只有80%（16/20）出现骨髓水肿（P =.012）。
结论
运动员的影像学表现和临床病程与一般人群不同。他们的症状对保守治疗比非运动员组更难治愈。因此，对于有症状的ANS病例，尤其是运动员，可考虑早期手术治疗。
证据级别
III级，回顾性比较病例系列。
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